Vermont Memory Care (Residential Alzheimer’s Care): Rules, Costs & Financial Help

Last Updated: April 29, 2024


In Vermont, regulations say that an assisted living residence must provide housing, healthcare, and personal care services for older adults. Assisted living is meant to be home-like. The state requires a private bedroom and private bath for every resident, as well as a living space and kitchen. Regulations also say that an assisted living residence must promote self-direction and active participation in decision-making. Health monitoring and medication management assistance are also required.

Vermont has a relatively older population compared to other states, roughly 18% of Vermonters are seniors. Because of this, the state offers more support to people in assisted living. For example, regulations require larger rooms in residences than in other states. Also, Vermont Medicaid has multiple programs to help pay assisted living costs, while many other states have at most one.

Special approval from the state’s Department of Disabilities, Aging, and Independent Living is required for a residence to admit people with dementia into memory care or Alzheimer’s special care units. The facility needs to show that it can handle the specialized needs of people with dementia. Requirements include a dementia-friendly physical layout, activities, and special training for staff on communicating with people who have Alzheimer’s or dementia.

There are approximately 17 memory care communities in Vermont. They range in size from apartment-complex-style to smaller home-like residences. For help finding memory care to meet your family’s needs and budget, click here.

 Did You Know? Vermont is one of the oldest states, with roughly 18% of the population over 65. That makes it the 4th highest in the country. The number of people with Alzheimer’s disease is expected to grow from 13,000 in 2020 to 17,000 in 2025, a whopping 30% increase. That is among the highest growth rates expected in the U.S.


How Much Does Memory Care Cost in Vermont?

The average cost of assisted living with memory care per month in 2024 in Vermont is $6,877. Vermont is one of the more expensive states for memory care, with a monthly rate well above the national average of $5,884. New England is generally an expensive part of the country for assisted living. In Burlington, memory care costs about $8,308 per month. In other areas in Vermont, outside the Champlain Valley, memory care costs average about $6,559 per month.

  In Vermont, free assistance is available to help families locate a memory care home to meet their needs and budgets. Get help here.

Looking outside the state might be a good way to find more affordable memory care, but Vermont’s eastern neighbor New Hampshire is one of the most expensive states in the country for memory care, averaging about $7,911 per month. To the west, New York state averages much less, about $6,003 monthly, but costs vary widely there. The bottom line is that prices can be quite different in different regions of these states. Be sure to investigate all options before choosing a home, especially if cost is one of your biggest issues.


Vermont Assisted Living Laws & Regulations

 COVID-19 Measures (updated Oct. 2022)
The additional measures left due to Covid are:
Residents- Their temperatures are checked and patients are also tested regularly.
Visitors- Can visit loved ones, must wear a mask, and temperature is checked upon entry.
Staff- Have temperatures checked upon entry and are regularly tested.

Admissions Process & Requirements

Within 14 days of moving into a Vermont assisted living community, every new resident must be evaluated using the Vermont Resident Assessment Form, which you can see here. This evaluation must be done by a registered nurse who works for the residence. Information including the ability to perform activities of daily living like eating and bathing is used to create a personalized service plan. This helps staff know how to best support and care for patients so they stay healthy and as active and engaged as possible. These service plans are then regularly updated.
The cost of evaluating might be included in the community’s base rate, or there may be a one-time community fee that covers move-in costs including the development of the service plan. This usually runs between $1,500 and $2,500.

Before moving in, any potential resident in Vermont assisted living must be provided a description of all rates and charges and an explanation of how those costs might change. There should never be surprises in billing. A disclosure form is available from any of these residences if asked for, which must include the following information:

– Services the residence can provide

– Public programs and benefits that the residence accepts or delivers

– All policies related to eviction

For memory care, the residence must provide a written statement of its philosophy as well as details on how the special needs of people with Alzheimer’s are met there. An official diagnosis of dementia is not required in Vermont for someone to move into memory care.

An assisted living residence cannot admit someone who needs full-time nursing care, or who otherwise requires a level of care that the residence can’t provide. Residents who pose a threat to themselves or others may not be admitted or may be evicted if they already moved in.

While it is possible to move into memory care on short notice in Vermont, this is usually not a good idea. Finding the right residence is a process that should take weeks or months of investigating options, taking tours, and asking questions of residents and staff before making a final decision. The person with dementia will also be able to provide more input the sooner you begin looking. Ideally, you would start the search before a move becomes necessary.


Facility / Residence

In Vermont assisted living bedrooms and living units that are larger than in most other states. Units must be at least 225 square feet, with a bed, bathroom, living space, kitchen, storage, and lockable door. All units are for a single person unless a patient chooses to have a roommate.

Regulations do not require dementia-friendly design features in memory care. Studies have shown that people with dementia can benefit from easy-to-navigate layouts, secure outdoor areas, and bright lighting and paint colors. As you investigate options, keep an eye out for these design elements and think about whether your loved one with dementia will be comfortable within the spaces.


Staff & Training

There are no staff-to-resident ratios in Vermont assisted living. That means there must always be adequate staffing to meet the needs of every resident. All assisted living homes must have a state-certified director who is responsible for the day-to-day management of the residence. Directors must receive 20 hours of continuing education annually, in courses related to the care of residents. Anyone working directly with residents must receive at least 12 hours of training annually, covering:

– Residents’ rights

– Fire safety and emergency evacuation

– Emergency response

– Reporting abuse, neglect, or exploitation

– Communicating with residents

– Infection control

– General supervision and care guidelines

Additionally, 24 hours of continuing education is required in:

– Alzheimer’s disease

– Medication management

– Behavioral management

– Transfers (getting in and out of bed)

– Infection control

– Toileting

– Bathing


Evictions & Discharges

Vermont regulations say someone can be evicted for two reasons:

– Behavior that poses an immediate threat to themselves or others

– Care needs cannot be met at the residence

These are pretty vague. Still, another stipulation in Vermont assisted living is that the process for evictions must be provided in writing to potential residents. Memory care homes can create their own rules for evictions, and you must be very clear on those rules before agreeing to a move-in contract. Can someone be evicted for non-payment of bills? Is verbal abuse or aggressive behavior considered threatening? What is the process for appeal?

Before agreeing to a move-in contract, you need to know the answers to these and any other questions related to evictions. Get the answers in writing, because unfair evictions are a major problem in assisted living nationwide. If your loved one has received an eviction notice and you need to know the next steps, click here.


Financial Assistance for Residential Alzheimer’s Memory Care

Choice for Care (CFC)

The Choices for Care is a Medicaid program that provides additional long-term care benefits so individuals can live more independently and not need to move into a nursing home setting. Different branches of this program are aimed at helping the most needy through priority and benefit amounts. Benefits include assistance with activities of daily living, laundry, meal prep, transportation, adult day care, respite care, home modifications, and case management. Participants can live in their homes, that of a family member, or in an assisted living community. To be eligible, one must qualify for Medicaid in Vermont in 2024. Eligibility requirements include monthly income less than $2,829, countable assets less than $2,000, and a documented need for a nursing home level of care. Through CFC, your loved one can self-direct their care by hiring the caregiver of their choice which can include friends and family members. More information and details on how to apply can be found on the program’s website by clicking here.


Assistive Community Care Services (ACCS)

Vermont’s Medicaid recipients who need extra supervision, but don’t require full-time nursing care, may be eligible for the Assistive Community Care Service program. This is a program that provides funds to cover long-term care expenses including some in assisted living. The benefits can include health monitoring, case management, and help with activities of daily living. Consumer direction of services is not available under this program, meaning the state guides care providers. A person must already be enrolled in Medicaid to receive help under this program. The 2024 eligibility requirements are monthly income less than $1,300, countable assets less than $2,000, and a need for help completing activities of daily living. Click here to enroll. Contact your nearest Vermont Agency of Human Services office to apply.


Attendant Services Program (ASP)

This program under Vermont Medicaid or Green Mountain Care is for people who cannot live alone and need a little extra help staying out of more expensive nursing homes. The Attendant Services Program is meant to keep people in their homes, but the state will consider applicants who live in assisted living communities (including those with memory care). Eligibility requirements for Medicaid in Vermont in 2024 making less than $1,300 per month (unless one lives in Chittenden County where the income limit is $1,408). This is a self-directed benefit, so recipients have a say in how they will use the funds to pay for care. Individuals can also hire the caregiver of their choosing which can include friends and family members. Benefits range from help with activities of daily living to chore help, meal prep, medication management, and transportation. For more information, click here. To apply, contact the Vermont Department of Disabilities, Aging, and Independent Living.


Adult Day Services Program

The Adult Day Services is a Medicaid program that promotes independent living through daycare benefits for those who qualify. Participants can also receive meals, transportation, medication management, assistance with activities of daily living, and skilled nursing. Eligibility requirements in Vermont are making less than $1,300 per month, countable assets less than $2,000, and a medical need for help with two or more activities of daily living, nursing care, a need for therapy, emotional support, or help with nutrition. For more information including details on how to apply, click here.

  The 4 programs above are all Medicaid programs. See Vermont’s Medicaid eligibility criteria or take a quick online Medicaid eligibility test.


Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia and different pension types.


VA Pensions

There are three types of VA Pensions available. The benefits change annually and are valid from December 2023 to December 2024. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,551

– Veterans with dependent spouses or children up to $21,674

– Surviving spouses without dependent children up to $11,102

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $27,609

– Veterans with dependent spouses or children a maximum of $32,729

– Surviving spouses without dependent children a maximum of $17,743

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $20,226

– Veterans with dependent spouses or children a maximum of $25,348

– Surviving spouses without dependent children a maximum of $13,568

 More information on VA Pensions’ eligibility criteria, payment rates, and the application process are available here.


Veterans Homes

There is one veterans’ home in Vermont. The Vermont Veterans’ Home is located in Bennington, in the southwestern corner of the state. It is a facility that provides long-term residential care for veterans. In addition to nursing home care and assisted living, memory care is provided in a certified Alzheimer’s unit. Neighboring states also have veterans’ homes. Your loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, New York has five homes statewide. Additionally, Massachusetts has two facilities and New Hampshire has one. More info.


Other Options

1) Eldercare loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) Tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.