No family can do this alone forever. Using outside help is not giving up — it often lets people with dementia stay at home longer and keeps caregivers healthy.
The main options
In-home help
Aides who help with bathing, dressing, meals and companionship, from a few hours a week to around the clock. Medicare generally does not pay for ongoing personal care at home; Medicaid waivers, VA benefits or long-term care insurance may.
Adult day centers
Daytime programs with activities, meals, social connection, and often health services like medication help and nursing checks. The person lives at home; the caregiver gets time to work or rest. Many centers specialize in dementia. Costs are usually far lower than full-time care, and Medicaid waivers or the VA may help pay.
Respite care
Short-term care that gives family caregivers a break — a few hours, a weekend, or a week — at home, at a day center, or in a residential setting.
Assisted living and memory care
Residential settings with help with daily tasks. Memory care units add secure design, specially trained staff and dementia-focused activities. Usually paid privately; some states' Medicaid programs help.
Nursing homes
24-hour nursing care for people with complex medical needs. Medicare covers only short stays after a hospitalization; Medicaid covers long-term stays for those who qualify.
PACE
Programs of All-Inclusive Care for the Elderly coordinate medical care, day center services and home care for people who qualify for nursing-home-level care but want to live at home. Available in many areas.
Hospice and palliative care
Palliative care focuses on comfort at any stage. Hospice, covered by Medicare, supports people in the late stage and their families — often at home — when life expectancy is likely six months or less.
Medicare's GUIDE program
GUIDE is a Medicare program that began in July 2024 and is planned to run for eight years. For people with dementia on Original Medicare (Parts A and B) who live at home or in assisted living — not in a nursing home or hospice — participating providers offer care coordination, caregiver training and support, a 24/7 support line, and some respite services. Search for a participating program on the CMS website or ask the Alzheimer's Association Helpline (1-800-272-3900).
Visiting a day center or memory care? Take this checklist.
Finding local help
- Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov — connects you to your local Area Agency on Aging.
- Veterans: ask the VA about adult day health care, respite and home care.
- Medicaid: your state's home- and community-based services waivers can pay for day centers and in-home help.
When it's time to consider more care
- Safety concerns — wandering, falls, leaving the stove on — are increasing.
- Care needs have outgrown what you can safely do.
- Your own health is suffering.
- The person would benefit from more company and structure than home can offer.
Many families feel guilt about this. Choosing more care is often an act of love for both of you. Read more for families.
Sources
Reviewed September 2026. Education only — not medical, legal or financial advice.