Vermont Memory Care Facilities

For decades, Vermont has frequently not been at the top of the list when talking about retirement. You could probably attribute this to a number of factors, from the location of the state in the far northeast part of the United States to its size (sixth smallest in the country), and to its limited population (second smallest in the US in terms of people). Yet, Vermont memory care communities are far from inferior to the rest of the costly northeast for elderly care.

Vermont may not be your typical state because while many other states rank in the Top 5 or Top 10 for most expensive in terms of all forms of senior care, including dementia care, Vermont’s Alzheimer’s care homes are offered at reasonable prices. Currently ranked 17th in our nationwide ranking of dementia care facilities by price, the State of Vermont offers prices far closer to the national average yet provides access to the same high-quality healthcare, plus a scenic landscape of the American northeast.

Detailed Cost of Memory Care in Vermont

The national median for Alzheimer’s care in the United States is $160 per day, or $4,800 per month. Compared to Vermont, which is just $4 more per day based on the median, the dementia care costs are nearly identical. It’s comforting news for seniors on the east coast who simply can’t afford the extremely high costs of Connecticut, Massachusetts, New York and New Jersey.

Affordable Vermont memory care facilities can get even cheaper than that, as the lowest reported room for Alzheimer’s care in the state was recorded at $94 per day, while others can be found lower than the state median at approximately $120 to $140 per day. On the other side of the balance, the most expensive Vermont dementia care homes can reach prices of $240 to $280 per day, far closer to what you would expect to find in costly nursing homes in Massachusetts and Connecticut.

The biggest problem with Vermont is the lack of senior housing. The state has only a little over 600,000 people and fails to parallel the selection and variety for dementia care offered in other northeastern states that are far denser. So, while fewer people may be seeking to relocate to memory care communities in Vermont compared to other neighboring states, the competition can still be intense due to the limited variety of facilities in the state.

The best cities to start with for dementia care search are Burlington, Essex, Colchester, Bennington, Rutland and Milton.

Medicaid and Medicare Coverage of Memory Care in Vermont

Memory care facilities in Vermont are designed to provide specialized care for individuals dealing with Alzheimer’s disease, dementia, and other cognitive impairments. These facilities offer services such as 24/7 supervision, structured activities, and personalized care plans. Understanding how Medicaid and Medicare cover these services in Vermont can help families manage costs effectively.

Medicaid Coverage of Memory Care in Vermont

Medicaid is a joint federal and state program that provides healthcare coverage for individuals with low income and limited resources. In Vermont, Medicaid plays a significant role in covering long-term care, including memory care services.

1. Vermont Choices for Care Program
   Vermont Medicaid offers a program called Choices for Care, which is part of the state’s long-term care waiver program. This program helps seniors and individuals with disabilities access care in a variety of settings, including memory care facilities.

   • Eligibility: To qualify, individuals must meet both financial and medical criteria. Financial eligibility is based on income and asset limits, which are updated annually. Medical eligibility requires an assessment to confirm the need for memory care or other long-term care services.
   • Services Covered: Choices for Care covers services such as personal care assistance, help with daily activities, case management, and specialized memory care services. It can also include respite care for families and caregivers.

2. Institutional Care in Memory Care Facilities
   For individuals who require full-time care in a residential memory care facility, Vermont Medicaid can help cover room and board costs, personal care services, and medical supervision. However, not all memory care facilities accept Medicaid, so it’s important to verify this with the specific facility.

Medicare Coverage of Memory Care in Vermont

Medicare is a federal program primarily for individuals aged 65 and older or those with certain disabilities. While Medicare provides coverage for many healthcare needs, its support for memory care is more limited than Medicaid.

1. Coverage for Short-Term Care
   Medicare may cover short-term stays in skilled nursing facilities or rehabilitation centers for individuals with memory-related conditions, but only under specific conditions:

   • A qualifying hospital stay of at least three days.
   • A need for skilled nursing or rehabilitation services, not just custodial care.

   These short-term stays may include some aspects of memory care, such as physical or occupational therapy, but not long-term residential care.

2. Outpatient and Medical Services
   Medicare Part B can help cover medical services related to dementia, including doctor visits, diagnostic tests, and certain outpatient treatments. Medicare Part D may cover prescription medications for managing symptoms of dementia, although it doesn’t cover all medications.

3. Limitations
   Medicare does not cover the cost of living in a memory care facility or the custodial care provided there. Families must look to other resources, such as Medicaid, private insurance, or personal savings, to cover these expenses.

Combining Medicaid and Medicare Benefits

For individuals who qualify for both Medicaid and Medicare (known as dual eligibility), the programs can work together to cover different aspects of memory care.

• Medicare typically covers medical and acute care services, while Medicaid provides for long-term care, including memory care.
• Medicaid can also cover Medicare premiums, deductibles, and co-pays, easing the financial burden on families.

Important Considerations for Vermont Families

• Facility Acceptance of Medicaid: Not all memory care facilities in Vermont accept Medicaid, so families should confirm this before selecting a facility.
• Waitlists for Medicaid Beds: Some facilities may have a limited number of Medicaid-funded beds, resulting in waitlists. Planning ahead is crucial.
• State-Specific Rules: Vermont Medicaid programs and services are state-specific, so families should consult the Vermont Department of Disabilities, Aging, and Independent Living (DAIL) or a Medicaid specialist for personalized guidance.

Memory Care vs Dementia Care vs Assisted Living in Vermont

In Vermont, understanding the distinctions between memory care, dementia care, and assisted living is essential for families seeking the best care options for their loved ones. These communities cater to seniors with different needs, ranging from general assistance with daily tasks to specialized care for those experiencing memory loss.

Assisted Living in Vermont

In Vermont, assisted living residences are also known as residential care homes. These facilities are specifically designed to support seniors who need help with daily activities but still want to maintain as much independence as possible. The goal is to provide a safe, supportive environment where residents can live comfortably while receiving assistance when needed.

Typically, assisted living communities in Vermont provide the following services:

• Meals and nutrition: Three daily meals are served, often catering to specific dietary needs.
• Housekeeping and laundry: Regular cleaning of residents' living spaces and laundry services ensure a tidy and comfortable environment.
• Personal care assistance: Help with activities of daily living (ADLs), such as bathing, grooming, dressing, and mobility.
• Social and recreational activities: Engaging programs that encourage social interaction and physical activity, contributing to the well-being of residents.

For many seniors, assisted living offers a balance of independence and necessary support. These communities often have a designated memory care unit, which provides additional services for residents with Alzheimer’s or other forms of dementia.

Memory Care and Dementia Care in Vermont

Both memory care and dementia care focus on the needs of individuals with cognitive impairments, such as Alzheimer’s disease or other forms of dementia. While these terms are often used interchangeably, there are subtle distinctions that families should be aware of.

1. Memory Care: Memory care is a specialized type of care within many assisted living communities, specifically designed to support individuals with memory loss. These units provide:

   • Structured routines: Seniors in memory care units typically thrive in a structured setting, where daily activities are predictable and comforting. This helps reduce confusion and anxiety.
   • Safe environment: Enhanced security features, such as secured doors and monitored areas, help prevent wandering and ensure residents' safety.
   • Personalized care plans: Memory care communities develop individualized care plans to address the unique cognitive needs of each resident.
   • Engagement and stimulation: Therapeutic activities, such as music therapy, art, and memory exercises, are incorporated to help maintain cognitive function and improve emotional well-being.

2. Dementia Care: Dementia care is often integrated into memory care units or can be a separate, standalone service in specialized facilities. It involves a more intensive approach for seniors who are in the later stages of cognitive decline and require constant supervision and support. Dementia care services include:

   • 24/7 supervision: Continuous care and monitoring by skilled professionals.
   • Behavioral support: Specialized strategies are used to manage common dementia-related behaviors, such as aggression or confusion.
   • Therapeutic interventions: Cognitive and physical therapies tailored to each stage of dementia to maintain quality of life.

How Seniors Benefit from Memory Care Units

Seniors in memory care units or dementia care units tend to benefit from a structured, secure environment that is designed specifically for their cognitive and emotional needs. These units typically create a smaller, more intimate community of residents, all of whom share the experience of having Alzheimer's disease or other types of dementia, though at varying stages. The common factors among them help foster a sense of connection and understanding.

• Comfort in structure: Seniors with memory loss often find comfort in a routine, where they know what to expect from day to day. Structured schedules for meals, activities, and rest help reduce stress and confusion.
• Safety measures: Memory care units are equipped with security features that ensure residents cannot wander into unsafe areas, providing peace of mind to families and caregivers.
• Specialized care: Trained staff with experience in dementia care are always available to meet the specific needs of each resident, offering compassionate support and engagement.

Choosing the Right Care Option in Vermont

When choosing between assisted living, dementia care, or memory care in Vermont, families should consider the level of care their loved one requires:

• Assisted Living: Ideal for seniors who need help with daily activities like dressing, bathing, and meal preparation, but who do not have significant cognitive decline.
• Memory Care: Suited for seniors with early to mid-stage memory loss due to Alzheimer's or other dementia-related conditions, offering a structured, supportive environment.
• Dementia Care: Best for individuals with advanced dementia who need round-the-clock care, supervision, and a high level of personal attention.

Vermont Dementia Care - Amenities

Standard amenities in Vermont memory care facilities include servings of nutritional daily meals, housekeeping and hygiene, scheduled programs and activities, personal productivity tasks, and leisure activities.

Well-trained staff are aware that dementia and Alzheimer’s are very complicated cognitive disorders, and thus treatments are often varied. These include therapies to keep the brain as healthy and active as possible, encouraging socialization, and the presence of a loving network of people. Each person dealing with Alzheimer’s is unique in their daily struggles, so the type of care one resident receives may be different in certain ways compared to another.

Below is a detailed list of amenities commonly found in Vermont’s memory care facilities:

1. Secure and Safe Environments

Memory care facilities in Vermont prioritize safety through:

• Secured Perimeters: Gated outdoor spaces to prevent wandering.
• Monitored Entrances and Exits: Ensuring residents' safety at all times.
• Emergency Call Systems: In-room and community-wide systems for immediate assistance.
• Slip-Resistant Flooring: To reduce the risk of falls.

2. Specialized Care Services

Residents benefit from personalized care plans that address individual needs, including:

• 24/7 Caregiver Support: Staff trained in dementia and memory care.
• Medication Management: Administration and tracking of prescribed medications.
• Health Monitoring: Regular assessments by licensed nurses.
• Assistance with Daily Living Activities (ADLs): Help with bathing, dressing, eating, and mobility.

3. Cognitive and Social Engagement Programs

Programs are designed to stimulate cognitive function and promote social interaction:

• Memory Enhancement Activities: Games, puzzles, and reminiscence therapy.
• Structured Daily Schedules: To reduce confusion and anxiety.
• Group Activities: Music therapy, art classes, and gardening.
• Intergenerational Programs: Opportunities for residents to engage with children and young adults.

4. Comfort-Focused Accommodations

Facilities in Vermont often include:

• Private or Semi-Private Rooms: Designed to feel like home.
• Personalized Décor: Encouraging familiarity and comfort.
• Accessible Bathrooms: With grab bars and walk-in showers.
• Communal Spaces: Cozy living rooms, dining areas, and outdoor patios.

5. Nutritious Dining Options

Healthy and dementia-friendly dining options are a key feature:

• Chef-Prepared Meals: Tailored to meet dietary needs.
• Assistance During Meals: For residents who need extra help.
• Hydration Stations: Accessible water and beverages throughout the day.

6. Specialized Therapies

Memory care facilities in Vermont often provide therapies tailored for cognitive decline, including:

• Pet Therapy: Interaction with animals for emotional support.
• Music and Art Therapy: Stimulating memory and creativity.
• Physical Therapy: Exercises to maintain mobility and reduce the risk of falls.

7. Family Support and Resources

Many facilities offer resources to help families stay connected and informed:

• Support Groups: For families navigating memory care challenges.
• Education Programs: Workshops on dementia care and disease progression.
• Visitation Policies: Flexible options to maintain family connections.

8. Transportation Services

Convenient transportation ensures residents can attend medical appointments or participate in off-site activities:

• Scheduled Rides: For doctor visits or social outings.
• Accessible Vehicles: Designed for those with mobility issues.

9. Recreational Spaces

To support an active and engaging lifestyle, many facilities provide:

• Outdoor Walking Paths: Safe and scenic routes.
• Gardening Areas: Enabling residents to connect with nature.
• Activity Rooms: Spaces for crafts, puzzles, and games.

10. Technology Integration

Modern memory care facilities in Vermont incorporate technology for better care:

• Wearable Devices: Monitoring health and activity.
• Interactive Tablets: For games, therapy sessions, and communication.
• Digital Memory Stations: Featuring photos and videos to spark recollection.

Vermont Memory Care Admission Checklist

Within two weeks of moving into an assisted living community in Vermont, a new resident should be evaluated using the Vermont Resident Assessment Form. The evaluation must be done by a registered nurse.

Before admitting the resident into a care facility, all rates and description of charges should be outlined to them explicitly, including the explanation and inclusions. For memory care, a written statement of the facility's mission and philosophy must be added as well, and how the special care unit will address the needs of the residents should be defined.

Seniors diagnosed with Alzheimer's disease or other forms of dementia can be accepted in a facility’s special care unit of memory care. However, there are some conditions that may disallow an individual from admission:

· Requires a respirator or a ventilator

· Requires oral, nasopharyngeal or tracheal treatments

· Have Stage 3 or 4 decubitus ulcer

· Have acute and severe illnesses requiring nursing care provided in a general or special hospital

· Needs two people to assist in bed or chair transfer

Secured Memory Care Units in Vermont

Memory care units in Vermont are usually within assisted living facilities, and security management is already in place in this environment. These units have tighter and more controlled entry and exit points in the dementia-specific wing or floor.

Since individuals with Alzheimer's or any other forms of dementia experience lapses of forgetfulness and episodes of disorientation and confusion, they should stay within the facility's premises. Thus, access points are closely monitored.

Vermont memory care units are expected to keep their residents safe and at home. Although gates and doors might be more measured, there are open areas on the grounds where the seniors can freely walk and socialize with fellow residents.

Below is a detailed list of the most common security measures in memory care facilities across the state:

1. Secured Entry and Exit Points

Memory care facilities typically have restricted access points to ensure residents cannot wander off unsupervised. These facilities often feature secure entrances and exits that are locked or controlled by electronic keypads or biometric systems. This helps prevent residents from leaving the premises accidentally or without supervision, reducing the risk of wandering.

• Fob Access Systems: Some facilities utilize key fob systems or access codes for authorized personnel and visitors, further ensuring that only those who are permitted can enter or leave the building.
• Alarmed Doors and Windows: Certain doors or windows may be equipped with alarms that alert staff immediately if someone attempts to open them without authorization.

2. Wandering Prevention Systems

Wandering is a common concern among individuals with memory impairments, and Vermont memory care facilities implement various strategies to reduce the risk of wandering.

• Electronic Tracking Systems: Many memory care centers use wearable devices, such as wristbands or pendants, equipped with electronic tracking features. These devices are connected to the facility’s security system, allowing staff to monitor the movement of residents throughout the building and receive alerts if someone enters a restricted area or exits the premises.
• Motion Sensors: Sensors placed in hallways, rooms, and near exits can detect movement and alert staff if a resident is attempting to wander away from safe areas.

3. 24/7 Staff Monitoring

Continuous oversight is a key element of memory care security. Staff members are trained to observe and assist residents, ensuring that any safety concerns are quickly addressed.

• On-Site Staff: Memory care facilities typically have staff available around the clock, including nurses, caregivers, and security personnel. This ensures that residents are always under supervision, particularly during late-night hours when wandering incidents may be more likely to occur.
• Observation Rooms: Some facilities include designated observation areas where staff can monitor multiple residents at once via video surveillance.

4. CCTV Surveillance

Closed-circuit television (CCTV) systems are an essential component of security in most memory care facilities. These systems allow staff to monitor activities in common areas, corridors, and outside the building in real-time. Cameras are often placed in locations where residents are most likely to spend time, such as lounges, dining areas, and hallways.

• Real-Time Monitoring: Some facilities have 24/7 monitoring of CCTV footage, allowing for immediate intervention if a safety issue arises.
• Recording Capabilities: CCTV systems also record footage for later review, which is important for resolving incidents or ensuring compliance with safety protocols.

5. Controlled Access to Rooms

To maintain a safe and secure environment, residents’ rooms may be equipped with additional security features.

• Locked Rooms: Many facilities utilize keyed or electronic locks for resident rooms to prevent unauthorized access. This helps protect the privacy and safety of residents while also allowing staff to monitor any changes or potential hazards within rooms.
• Safe Spaces: Some facilities design "safe" or "quiet" rooms where residents can retreat if they become agitated or confused. These rooms are often monitored closely to ensure safety.

6. Environmental Design for Safety

Memory care facilities are built with specific architectural designs that minimize risks and enhance security.

• Non-Slip Flooring: Floors are designed to be slip-resistant to reduce the risk of falls, which are particularly dangerous for individuals with memory impairments. Some facilities install cushioned flooring to minimize injury in case of a fall.
• Well-Lit Areas: Proper lighting is crucial for preventing accidents. Memory care facilities often use bright lighting in hallways and common areas to reduce the risk of residents tripping or bumping into obstacles.
• Familiar Environment: To reduce confusion and disorientation, the facility may use clear signage, color-coded zones, and familiar landmarks to guide residents and make it easier for them to navigate.

7. Emergency Response Systems

Emergencies, such as medical incidents or fires, can pose significant risks to residents in memory care facilities. To address this, Vermont facilities implement a variety of emergency response measures.

• Emergency Call Buttons: Resident rooms and bathrooms are typically equipped with emergency call buttons that can be used by residents to alert staff if they need help.
• Fire Alarms and Sprinklers: All memory care facilities are required to comply with state fire safety codes, which include installing fire alarms, smoke detectors, and sprinkler systems to protect residents.
• Evacuation Plans: Each facility should have a clearly defined and practiced evacuation plan in case of emergencies, including fire drills and designated assembly areas.

8. Visitor and Staff Screening

To ensure the safety of residents, memory care facilities in Vermont often require thorough screening of visitors and staff.

• Visitor Check-In: All visitors must check in at the facility’s front desk and may need to show identification before entering. Visitors may also be required to undergo health screenings, particularly during flu season or other contagious outbreaks.
• Background Checks for Staff: All employees undergo extensive background checks, including criminal record checks, to ensure that they do not pose a risk to the residents. Staff are also trained to handle emergencies and respond appropriately to medical or behavioral situations.

9. Behavioral and Medical Interventions

For residents who may exhibit challenging behaviors due to their memory impairments, facilities use specialized interventions.

• De-Escalation Training: Staff members receive training on how to de-escalate potentially dangerous or disruptive situations calmly and effectively. This training helps prevent physical confrontations and keeps the environment safe.
• Medication Management: Proper medication management systems are implemented to ensure that residents receive the right medications at the right times. This reduces the risk of accidents or health complications that could arise from medication errors.

10. Privacy and Dignity

While ensuring safety is paramount, it is equally important that the security measures respect the privacy and dignity of residents. Facilities in Vermont are designed to balance safety with the need for residents to feel at home.

• Private Spaces: Residents' personal spaces are designed to be private and comfortable. Staff members are trained to respect residents' privacy while ensuring they have the necessary assistance when needed.
• Person-Centered Care: Security protocols are tailored to each resident’s individual needs, ensuring that their sense of autonomy is maintained while still providing appropriate oversight and protection.

Vermont Memory Care Regulations

Care Plan

There should be a written care plan for every resident of a memory care facility. This is created by the Assisted Living Residences (ALR) or Enhanced Residential Care in collaboration with the resident or their legal representative.

The document should outline the essential services in maintaining a resident's requests, decisions, objectivity, and well-being. This individual care plan is reviewed once every year and when necessary, such as any changes in the resident's physical condition, behavior, and circumstances.

Facility

The state of Vermont has set specific size and feature requirements for memory care facilities’ living quarters, which are wider compared to those in other states. Each unit should be 255 square feet, lockable, and equipped with a bed, living space, bathroom, kitchen and storage.

All rooms are only for single occupancy. The only exception is when an occupant volunteers to have a roommate.

Medication Management

Capable residents are allowed to self-administer their medications. But for those unable, the management of medicines should be delegated and supervised by a licensed nurse. A facility's registered nurses are responsible for providing suitable training to the unlicensed staff members. The RNs are also accountable for delegating specific tasks to other members of the team.

Thorough observation and documentation are mandated for all prescriptions and over-the-counter medicines of the residents, whether self-administered or given with the staff members' assistance.

PNR medications can be administered by non-RN staff who are knowledgeable about the medicines' anticipated side effects. Insulin injections can likewise be done by staff members trained for that medical procedure and assigned by an RN.

Staffing Ratio and Training

Vermont doesn't require specific staff-to-resident ratios for memory care communities. Still, there should always be a sufficient number of qualified team members at all times, not just to provide the care and assistance needed by every resident but also to respond to emergency cases.

Every Vermont memory care facility should have at least one on-duty POC around-the-clock. The manager can delegate authority to a competent member of the team. For facilities with more than 15 residents, at least one awake staff should be on duty 24/7.

Staff members assigned to the Alzheimer's and dementia special care unit are required to undergo additional qualification screenings, orientation, and training specific to dementia care, behavior management, medication management, and infection control.

When Do You Move a Loved One to Memory Care?

It will rarely be your senior who'd volunteer to move to a memory care facility. Like anybody else, familiar faces of family and friends are comforting to them, and so is staying in a place that is significant to them and their life.

That's why the decision of moving a loved one to memory care usually falls on the immediate family members, which can be an overwhelming experience. They might have conflicting beliefs and may not reach a unanimous decision. It will be difficult, but if everyone puts the safety and overall well-being of their senior loved one as top priority, they will realize that there's so much positive impact a memory care community can provide.

To make you more at ease with your decision and more confident that it is the right approach, here are some factors and circumstances you might want to look into:

• You can't provide a safe and secure environment for your loved one with dementia.
• You start worrying about your safety and the safety of other people who have direct contact with them.
• Your senior is tired, scared, and depressed.
• You, as the primary caregiver, are exhausted, nervous and stressed.
• They wander, get lost, and unintentionally break society rules.
• You need to call the police and everyone in the neighborhood to help you find them.
• Your living conditions are subpar.
• Your relationship with your loved one is going downhill.
• They feel inadequate and prefer isolation.

These are not happy times at all, and keeping your loved one with dementia at home will do everyone concerned more harm than good. Address the situation with a sense of urgency. Create an opportunity where your loved one can thrive better and still live with a sense of freedom while being assisted by professionals who can provide the best possible care.

What to Ask When Touring a Vermont Memory Care Community

Your prospective memory care community's website and social media pages are a good pool of resources when you want to research about the place. It might make your scheduled tour more manageable and less of an overwhelming event.

When you set up an appointment to visit the facility, free up one whole day if possible. You need to give your full attention and time to this important meeting because it will greatly influence your future decision. You need to allot enough time to talk to the facility’s personnel without rushing. This tour is the perfect chance for you to ask questions and get the clarifications you need.

Before your visit, create a list of your inquiries. Avoid making a mental list and opt for a written list, or you may also type it on your phone. Segment your questions into sections to be sure you won't forget anything. Here is a sample list you can use as a reference. If you feel like the answers of the staff are vague, don’t hesitate to request for further explanation. Ask situational questions to address your what-ifs as well.

Cost and Expenses

• How much would the monthly stay cost? And what is included in the monthly rate?

• What are the other recommended services we can avail of, and how much will be the additional costs?
• Vermont has programs for assisted living, is memory care included?

Facility Background

• How many residents are currently living in the community?
• How many physicians, RNs, licensed nurses and caregivers do you have?
• How long have you been caring for residents with Alzheimer's or other forms of dementia?

Amenities and Activities

• What are the activities you provide your residents?
• Are they divided into groups when socializing or when engaged in activities? What is the grouping based on?
• What services does your facility offer to sustain the residents’ overall well-being?

Safety Management

• How safe is the community?
• How do you handle emergencies involving the residents?
• Will the residents feel restricted within the environment?

Family Involvement

• How can I be involved in my loved one’s care once they move here?
• How would I get updates about my loved one?
• Can the family take our senior out of the facility for a day?