Helping Dementia Residents Remain In
The Most Appropriate Setting
By: Coalition of NYS Alzheimer’s Association Chapters
T
hose in the world of long term care facilities know that not only is it the law (Olmstead v. L. C., 1999), it’s best
practice for residents to be in the least restrictive environment that’s required for their medical conditions. It keeps
people happier, healthier and more responsive.
Many individuals with dementia successfully reside in assisted living residences for many years, where they receive
support in a generally secure space. Unfortunately, some spend the bulk of their resources during their tenure and
become unable to afford the private-pay assisted living rate.
Sometimes, facilities are able to keep them right where they are. However, more often than not, these residents must go
on Medicaid and find a new residence that accepts Medicaid, unless the facility has operational and available Assisted
Living Program (ALP) Medicaid-eligible beds. This results in a move, usually to a skilled nursing facility – even though
they may not medically require that level of care. This option is contrary to long-standing best practices to keep people
with dementia in a familiar, less restrictive setting.
Creative ideas for retention
Various states, including New York, are brainstorming ways for people with
dementia who aren’t yet ready for nursing homes to remain in assisted living.
Some ideas include:
Offering state-funded voucher payments to these private-payers to avoid
premature discharge. The state would support the difference in what the
resident is able to pay vs. facility fees to keep people with dementia in the
best place for them.
Following the home- and community-based guidelines for residential living
outlined in the Creating a Dementia-friendly Memory Care Facility article
on page 28 in this issue. Understanding the behavior of those with
dementia and making their living situation as familiar and home-like as
possible could help retain residents longer in less restrictive settings.
Establishing facility scholarship funds to help residents who are no longer
able to afford the facility’s full rate.
The Coalition of NYS Alzheimer’s Association Chapters is the leading
statewide organization advocating for all New Yorkers affected by
Alzheimer’s and dementia. The Coalition is actively researching funding
options for those with dementia in assisted living to ensure this population
remains in the most appropriate setting to avoid unnecessary, disruptive
changes. For further discussion on this matter, please call the Coalition at
518.867.4999, ext. 208.
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Adviser a publication of LeadingAge New York | Spring 2017