State Veterans Homes provide long-term care for veterans (and sometimes non-veteran spouses / widows and parents of veterans who have died in active duty), including those with Alzheimer’s disease and other forms of dementia. While commonly it is nursing home care that comes to mind when one thinks of State Veterans Homes, some facilities also offer domiciliary care (which can be thought of as assisted living), and adult day health care. Furthermore, some facilities offer memory care (sometimes called Alzheimer’s care units), in which specialized care for persons with dementia is provided. (To be clear, not all State Veterans Homes provide all of the same long-term care services).
The variety of care services offered in State Veterans Homes gives veterans with dementia flexibility in meeting their care needs, as the type and level of care needed evolves as the disease progresses. (The level of informal support a veteran has is also a factor in the type of care that is required). For instance, adult day health care might be beneficial for a veteran with mid-stage Frontotemporal dementia (FTD), also called Pick’s disease, who requires daytime supervision and assistance with daily living activities while his / her informal family caregiver works. Now, consider the same veteran with mid-stage FTD, but in this situation, the family is unable to provide informal care. In this case, the veteran might require more extensive care, such as assisted living. And lastly, take a veteran with late-stage Lewy body dementia that is completely dependent on others for care assistance. With the high level of care needed, nursing home care is likely ideal (regardless of if informal support is available or not).
State Veterans Homes are a partnership between the U.S. Department of Veterans Affairs (VA) and each individual state. While the VA certifies the homes, the state owns and operates them. State Veterans Homes can be found in Puerto Rico and all 50 states, though the number of homes in any given state varies. (To find locations based on state, click here).
The availability of long-term care supports for veterans with dementia varies based on the particular state veterans home. However, the following types of care might be available.
• Adult Day Health Care – provides daytime supervision, companionship, social / recreational activities, meals / snacks, and assistance with daily living activities. Skilled nursing care and therapies (physical, occupational, and speech) may be available, and transportation to and from the facility might be provided. Adult day health care can serve as a good form of respite care for primary caregivers of persons with dementia.
• Domiciliary Care (Assisted Living) – an independent living situation that allows veterans supervision and some assistance with activities of daily living. This might be a good option for veterans who are in the early stages of dementia who can function with minimal assistance.
• Memory Care – a residential living option that provides specialized care for persons with Alzheimer’s disease and related dementias.
• Nursing Home Care – 24-hour skilled nursing. In late stage dementia, this level of care will likely be required.
While the cost of care in a state veterans home may be privately paid, it is not uncommon for veterans to require financial assistance. Examples of common assistance include the VA’s per diem aid program (for veterans who receive VA health care), the VA’s Aid & Attendance pension, and long-term care Medicaid.
Please note that veterans with dementia may have to pay a share of cost towards their cost of care. This depends on a variety of factors, such as the specific state veterans home, the veteran’s level of service connected disability rating (if applicable), a veteran’s assets, and a veteran’s income level.
The eligibility criteria for admission to state veterans homes differ based on the state in which one resides, and even between state veterans homes within any given state. That said, there are some general requirements for veterans with dementia that are usually standard across the board, such as the veteran must have been honorably discharged.
All State Veterans Homes require that veterans have a clinical (functional) need for care services. However, how this is determined is not consistent. For example, one state veterans home might require a doctor’s order for services, while another home might require the veteran to require assistance with a specific number of activities of daily living. Regardless of how clinical need must be demonstrated, veterans with mid-late stage Alzheimer’s disease and other forms of dementia likely will meet the requirement due to the cognitive and physical decline that comes with the progression of the disease.
Generally, there are no income or asset limits, but as mentioned previously, there may be a co-pay based on one’s financial means.
Some homes may require that a veteran be a current state resident for a specified period of time, while other homes may allow veterans who currently reside in another state to be eligible if their state is listed on their paperwork as home of record either upon their entry into service or their discharge from service.
Remember, some State Veterans Homes only allow admission to veterans, while others allow non-veteran spouses and widows and / or parents who had a child who died while serving in the military (these parents are referred to as “gold star” parents).
The application process for long-term care services in a State Veterans Home varies based on the specific residence. Therefore, it is suggested that veterans or their family members contact the state veterans home for which they would like to apply. To find contact information for state veterans homes based on state, click here.
VA social workers are available to provide more information about State Veterans Homes and assist veterans with dementia in exploring if this might be a good option for them. Furthermore, they can provide help with the eligibility process. VA social workers work at VA medical centers and can be contacted via one’s local regional VA medical center. Find local VA medical centers here.