What care programs are available for someone with Alzheimer's
Care programs for Alzheimer's disease fall into three main categories: adult day programs, in-home care services, and residential facilities. Each serves a different stage of the disease and a different living situation. Adult day programs let someone stay at home while attending structured activities a few days a week. In-home care brings a caregiver to your house for a few hours daily or around the clock. Residential facilities provide 24-hour supervision and medical care when home care is no longer safe or possible.
The right program depends on how much help the person needs, whether a family caregiver is available, and what your household can afford. Many people use more than one type over time — starting with day programs while living at home, then moving to in-home care, and eventually to a facility if the disease progresses.
Key Takeaways
- Adult day programs provide supervision, activities, and social connection during daytime hours while the person lives at home.
- In-home care services range from a few hours of help with daily tasks to 24-hour live-in support, and can be hired privately or through an agency.
- Residential care facilities include assisted living, memory care units, and nursing homes, each with different levels of medical supervision.
- Medicare, Medicaid, and long-term care insurance may cover some costs, but coverage rules vary widely by state and by the type of care.
- Your local Alzheimer's Association chapter can connect you to programs in your area and help you understand what each one offers.
Adult day programs and what they offer
Adult day programs are centers that open during business hours — usually 8 a.m. to 5 p.m. — where people with Alzheimer's spend the day in a supervised setting. Staff provide meals, activities tailored to the person's abilities, and social time with others. Some programs include basic health monitoring like blood pressure checks. The person goes home in the evening with a family member or caregiver.
These programs serve two purposes: they give the person with Alzheimer's structure, engagement, and peer connection, and they give the family caregiver a break during the workday. Many adult day programs are run by senior centers, hospitals, or nonprofit organizations. Some are specialized for memory loss; others serve mixed groups of older adults. Costs vary by location and program, typically ranging from $50 to $150 per day, though some programs offer sliding-scale fees based on income.
To find programs near you, contact your local Area Agency on Aging (you can find yours at eldercare.acl.gov) or call the Alzheimer's Association 24/7 Helpline at 800-272-3900. Staff can tell you which programs have openings and what each one specializes in.
In-home care: hiring and what to expect
In-home care means a caregiver comes to the person's house to help with daily tasks like bathing, dressing, meals, and medication reminders. Care can be a few hours a week or 24 hours a day, depending on need. Some people hire caregivers privately through word-of-mouth or online platforms; others use a home care agency that handles hiring, background checks, and payroll.
Agencies typically charge more than private hire — often $25 to $35 per hour for basic care, and more for skilled nursing — but they handle taxes, insurance, and replacement if a caregiver calls out. Private caregivers may cost less but require you to manage employment paperwork and verify their background yourself. Either way, it is worth asking about experience with dementia; caregivers trained in Alzheimer's care know how to respond to confusion and behavioral changes.
Medicare does not cover in-home care for daily living tasks, but Medicaid may in some states if the person meets income and asset limits. Long-term care insurance, if the person has a policy, may cover part of the cost. Veterans and their spouses may be covered through the VA Aid and Attendance benefit. Ask your state Medicaid office or the Alzheimer's Association what programs exist in your area.
Assisted living and memory care facilities
Assisted living facilities are residential communities where residents have their own apartment or room but staff are on-site to help with meals, medications, bathing, and activities. Memory care units are assisted living sections designed specifically for people with dementia — they have secured exits, staff trained in dementia care, and activities suited to cognitive decline. Both offer social connection and 24-hour supervision without the medical intensity of a nursing home.
Assisted living costs vary widely by location and services, typically $3,000 to $6,000 per month, though some charge more. Memory care units within assisted living usually cost $1,000 to $2,000 more per month than standard assisted living. Most facilities require a private pay deposit upfront; Medicare does not cover assisted living, but Medicaid covers it in some states if the person meets income limits. Some facilities offer a limited number of Medicaid beds, so ask about availability when you call.
When visiting a facility, ask about staff-to-resident ratios, how they handle wandering or aggression, what activities they offer, and whether family can visit anytime. The Alzheimer's Association publishes a checklist for evaluating memory care facilities on their website.
Nursing homes and skilled nursing care
Nursing homes provide 24-hour medical care, nursing staff, and supervision for people who need constant help with daily tasks and have complex medical needs. They are appropriate when someone with Alzheimer's can no longer be safely cared for at home or in assisted living — for example, if they wander frequently, refuse to eat, or have medical conditions requiring daily nursing attention.
Medicare covers up to 100 days of skilled nursing care if the person was hospitalized for at least three days first and is admitted within 30 days of discharge. After that, the person pays out of pocket or Medicaid covers it if they meet income and asset limits. Medicaid is the largest payer of nursing home care in the United States. Private pay costs average $8,000 to $10,000 per month, though this varies by region and facility.
Nursing homes are heavily regulated and inspected; you can look up inspection reports and complaints for any facility on the Centers for Medicare & Medicaid Services website at cms.gov. When choosing a home, ask about dementia care training, activities, visiting hours, and how they manage behavioral changes. Many families find it helpful to visit at different times of day to see how the facility operates.
Understanding costs and what insurance covers
The cost of Alzheimer's care depends on the type of program and where you live. Adult day programs typically cost $50 to $150 per day. In-home care ranges from $20 to $35 per hour for basic information to $50 or more per hour for skilled nursing. Assisted living averages $3,000 to $6,000 per month; memory care adds $1,000 to $2,000 more. Nursing home care averages $8,000 to $10,000 per month.
Medicare covers skilled nursing care in a nursing home for up to 100 days after a hospital stay, and some in-home skilled nursing services if ordered by a doctor. It does not cover long-term residential care or help with daily living tasks. Medicaid covers in-home care, assisted living, and nursing home care in most states if the person meets income and asset limits — but limits and covered services vary by state. Long-term care insurance, if purchased before diagnosis, may cover adult day programs, in-home care, assisted living, or nursing home care depending on the policy. Veterans benefits may cover care through the VA Aid and Attendance program or through VA community care programs.
To understand what you might be covered for, contact your state Medicaid office, your Medicare plan, or your insurance company directly. The Alzheimer's Association also offers a financial planning guide on their website.
How to find and choose a care program
Start by calling your local Area Agency on Aging or the Alzheimer's Association Helpline at 800-272-3900. Both can tell you what programs exist in your area, what each one costs, and whether openings are available. The Helpline is staffed 24 hours a day and can answer questions about care options, costs, and how to pay for care.
When you have narrowed down options, visit in person if possible. For adult day programs, ask about the daily schedule, activities, meals, and how staff handle behavioral changes. For in-home care, ask about background checks, training, and whether the agency or caregiver has experience with Alzheimer's. For residential facilities, ask about staff training, activities, visiting hours, and how they manage medical emergencies.
It is also worth asking whether the program or facility has worked with your insurance or Medicaid before, and whether they can help with paperwork. Many facilities have social workers on staff who understand the financial side and can guide you through the process.
Frequently Asked Questions
Can someone with Alzheimer's stay in an adult day program if they wander?
Most adult day programs can accommodate wandering if the person is otherwise safe and the program has staff trained in dementia care. Some programs have secured areas or outdoor spaces where people can move freely. When you call, describe the person's behavior and ask whether the program has experience managing it.
What happens if we can't afford in-home care or a facility?
Medicaid covers in-home care and residential care in most states if the person meets income and asset limits. Some adult day programs offer sliding-scale fees based on income. Contact your state Medicaid office or the Alzheimer's Association to learn what programs exist in your area and whether the person might be covered.
Can family members provide all the care at home without hiring help?
Some families do, but Alzheimer's care is physically and emotionally demanding. Caregiver burnout is common and can lead to health problems. Even a few hours a week of adult day program or in-home help can reduce stress and improve the quality of care. Many caregivers find that combining family care with professional help works best.
How do I know if it's time to move someone to a facility?
Consider a facility when the person needs 24-hour supervision, when in-home care is no longer safe or affordable, or when the family caregiver's health is suffering. A social worker or geriatrician can help you think through whether home care is still workable. The Alzheimer's Association also offers guidance on this decision.
Do I need to hire a care manager to help coordinate care?
A care manager (also called a geriatric care manager) can help coordinate services, manage paperwork, and monitor quality of care. They typically charge $100 to $200 per hour. Many people find this helpful if they live far from the person with Alzheimer's or if managing multiple services feels overwhelming. Ask your doctor or the Alzheimer's Association for referrals to care managers in your area.