The Veterans Affairs Home Improvements and Structural Alterations (HISA) grant provides financial assistance for home modifications in a disabled veteran’s home. This can be the home of a relative or a rental home, as long as it is the veteran’s primary residence. In some cases, veterans in medical foster homes and group homes can also receive a HISA grant. Eligible disabilities can be service-related or non-service related. Veterans with Alzheimer’s disease and other forms of dementia that exhibit moderate to severe mobility, coordination, or balance issues will likely qualify for the HISA grant because the need for home modifications has become medically necessary.
In terms of its relevance for dementia patients, the HISA grant can be used to make home modifications that help to improve a veteran’s ability to move within the home and prevent falls. For instance, wheelchair ramps can be built to allow access to and from the home, doorways can be widened to allow a wheelchair through, and in medically necessary cases, a walk-in bathtub can replace a standard bathtub.
HISA grants are awarded and administered via a veteran’s local regional VA Medical Center, specifically the Prosthetics and Sensory Aids (PSAS) Services Department.
As of 2023, veterans with dementia eligible for the HISA grant can be awarded a one-time benefit of $6,800 to veterans with service-connected disabilities or $2,000 to veterans with non-service-connected disabilities. This cash grant is a lifetime benefit, meaning a veteran can make approved home modifications until the funds are depleted.
The following are examples of approved Home Improvements and Structural Alterations. Please note that this is not a comprehensive list.
– Lowering kitchen and bathroom counters
– Lowering light switches and electrical outlets
– Lowering windows
– Addition of grab bars and handrails
– Installation of wheelchair ramps providing access to enter or exit the home (ramps must be permanent)
– Widening of doorways for wheelchair access
– Improving sidewalks or driveways to allow wheelchair users to/from the home
– Replacing standard bathtubs and showers with roll-in showers or walk-in bathtubs (when medically necessary)
– Replacing standard bathroom sinks with pedestal sinks
– Replacing carpeting with wood or vinyl flooring for easier wheelchair use
– Installing chair lifts
– Adding window shading or tinting
– Updating plumbing to support medical equipment and essential bathrooms
– Updating electrical to support life-sustaining equipment and essential bathrooms
– Addition of interior and exterior lighting
Many of the approved home modifications are relevant to people with dementia and these become medically necessary to provide a safe living environment. Since the symptoms of dementia vary based on the type and stage of dementia, necessary home modifications for dementia patients are not the same across the board. The following examples of approved improvements break down different spaces of the home to help with symptoms and improve your loved one’s quality of life.
– Improving safety. A common symptom of dementia is wandering. In terms of benefits through the HISA grant, approved modifications can be done to the entrances and exits of a home. That means that there can be special locks, devices (like window and door alarms), and fencing installed to keep your loved one safe.
– Improving interior and exterior lighting. Dementia damages the brain causing a loss of depth perception. Increasing lighting in smaller spaces so they become illuminated reduces the risk of people with dementia falling and being confused by what they are seeing. This can be done by putting more lighting in hallways, bathrooms, and outside the home.
– Improving bathrooms. Through the effects and damage of dementia to the brain, it can be hard for people to be active and move around independently. Modifications can be done to make it a safe environment and more accessible for your loved one to use the space. Approved benefits can be grab bars by the toilet and shower, non-slip flooring, taller toilet seats, and walk-in showers.
– Improving bedrooms. Dementia can greatly affect your loved one’s ability to sleep and cause anxiety (especially when the sun sets). Some modifications can be done to help create a relaxing safe space. Approved benefits can be bed rails, nightlights, window treatments, and safety sensors that let a caregiver know when there is movement in the room.
– Improving kitchens. Safety becomes a large issue in this space as cognitive function declines. The changes range from how someone can prepare their food to remember to turn off the stove. Approved benefits can be automatic shut-off valves for the stove or making counters and shelving easier to access by lowering them and making them dementia friendly.
The ability to match one’s home modification needs to their stage of dementia and level of functional need is what makes this program beneficial and independent living viable.
As of 2023, to be eligible for the HISA grant veterans of all ages with dementia must meet the following eligibility criteria.
– Be disabled, whether it be service-connected or non-service connected. For service-connected disabilities, a veteran must have a minimum disability rating of 50%.
– Be eligible and enrolled in the VA’s health care system.
– Have a physician’s prescription from a VA doctor indicating home modifications (including which ones) are medically necessary due to a specified medical diagnosis. The veteran’s name, home address, telephone number, and social security number must be included. A diagnosis of dementia, consequent loss of movement, and the inability to complete other common daily living activities can result in home modifications being medically necessary.
– For veterans who do not own the home in which they reside and wish to make home modifications, permission for home modifications must be granted by the home’s owner. This is done by providing a statement (signed and notarized) from the owner permitting the modification.
There are no specified income or asset limits for HISA grant eligibility. Furthermore, marital status does not impact a veteran’s eligibility.
Before applying for a HISA grant, a veteran with dementia must be eligible and enrolled for medical services via the VA. If a veteran is not currently enrolled in the VA health care system, they need to apply. Information about applying can be found here.
For veterans who are enrolled in VA health care and wish to apply for the HISA grant, the following documents must be submitted to the Prosthetic and Sensory Aids Service Department of one’s local VA Medical Center. For VA Medical Centers by region, click here.
1. A Veterans Application for Assistance in Acquiring Home Improvements and Structural Alterations (VA Form 10-0103) was completed and signed.
2. A VA doctor’s order stating that home modifications (including which home modifications) are medically necessary. This must include the veteran’s medical diagnosis, such as Alzheimer’s disease, Lewy body dementia, Frontotemporal dementia, and Huntington’s disease.
3. Renters must include a signed and notarized statement by the owner authorizing home modifications of the rental property.
4. An itemized estimate of the home modification cost in writing. The estimate must be done by a contractor who is licensed, bonded, and insured, and must include the price of labor, materials, inspections, and permits.
5. A color photograph of the area in the home which one wants to modify.
Veterans with questions about applying for VA health care and the HISA grant, or require assistance with the application process, might find working with an accredited VA representative helpful. Learn more here.