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Homemaker and Home Health Aide Care
In many cases, if the VA assesses that a veteran suffering from dementia needs help with three or more activities of daily living (ADL), they may pay for a community aid agency to send a trained aide to your home. This aide will be trained to help with activities of daily living but will not be able to provide skilled nursing.
Typical tasks an aide helps with:
Moving around within the home
Going to appointments
Eating
Using the bathroom
Bathing
Getting dressed
Personal grooming
Aides from the Homemaker and Home Health Aide Care program will be supervised by a registered nurse who will initially make a plan for the veteran’s daily living needs but will not visit on a regular basis. Aides can visit multiple times a week or just once a week, depending on need. Those without service-related disabilities will usually pay a copay for these services, but all enrolled veterans are eligible as long as they meet clinical need requirements.
Availability for this program is fairly wide, but there still may be some areas without it.
Veteran Directed Home Based Care (VD-HCBS)
Veteran Directed Home Based Care (also called VD-HCBS or just Veteran Directed Care) is an alternative approach to memory care and other healthcare needs that give the veteran and/or caregiver control. In this program, those in need of care sit down with a VA social worker or case manager to set a care budget based on actual needs. Supplies and the need for assistance, including aides, respite care, or even adult daycare, are all part of the budget. The patient has the freedom to select a capable family member to be their paid caregiver, if desired.
Once a budget is approved, any care provider who’s been included in the budget will be paid directly by the VA. Caregivers who purchase supplies included in the budget will be reimbursed from the budget.
This program gives incredible freedom to vets and their loved ones who are dealing with a dementia diagnosis. Receiving these funds gives families the power to make choices that truly suit their needs. This program is not available in all communities, so you will need to check someone from your nearest VA facility to determine if Veteran Directed Care is available to your family.
Aid and Attendance Benefit
Rather than a direct medical program, this benefit includes payments of extra pension funds based on need. If a healthcare team confirms that the veteran’s dementia makes it necessary for them to have aid and attendance to complete activities of daily living such as dressing, bathing, and cooking, then the monthly Aid and Attendance benefit (A&A) may be awarded.
Funds provided by this pension benefit can be used for a range of services. They might be used to pay for rent in an assisted living facility with a memory care unit, for care in a nursing home, medical foster home, or adult daycare, or for an aid who will come to the veteran’s own home. Restrictions may apply, and those who receive this benefit should always consult a VA social worker to make sure you are using funding appropriately.
Pension rates are determined using complex math that involves service history, income, dependents, spouses, medical expenses, assets, and disabilities. Some veterans with a regular VA pension plus the A&A or housebound benefit can receive over $22,000 each year from the VA. Rates are highly specific to the individual, however, and not everyone can qualify.
Another benefit that is separate from but often brought up alongside the A&A benefit is the Housebound Allowance. You will see this benefit mentioned in the link we’ve provided for the A&A benefit. The Housebound Allowance is also additional pension funding that those who already receive the general pension may qualify for. It’s important to note that Veterans cannot receive A&A and Housebound benefits simultaneously; the VA will determine which is the better fit. But if a medical care team can document that a veteran is unable to leave their home, the housebound benefit can be awarded at the same time as the VA pension.
Community Nursing Homes
Community nursing homes are residential medical facilities that include, at a minimum, 24-hour skilled nursing care for minor things like wound care or help with IV medication, occupational and physical therapy for those who need it, and access to social services. Many nursing homes also include their own memory care services, often in distinct units of the facility. Nursing homes may also offer hospice and palliative care, forms of care for the terminally ill that focus on comfort and pain relief rather than on improvement of the underlying condition.
The VA covers the cost of some community nursing home care at facilities that it approves, for those with a clinical need. VA officials routinely visit community nursing locations to verify that facilities are meeting VA care standards. Not all community nursing homes have room for new patients, and a patient may experience a wait time even if they are technically approved for admission.
VA Community Living Centers
VA Community Living Centers used to be called VA Nursing Homes. These community centers provide residential care to veterans at a similar level to that provided by community nursing homes, but they provide it in a more home-like atmosphere. These homes often allow residents to decorate their rooms and keep pets, and they host a variety of stimulating activities for veterans to enjoy.
There are approximately 100 VA Community Living Centers across the nation. Usually, to qualify for long term care at one of these facilities, a veteran needs to have a disability that is deemed to be 60% or 70% caused by a service-related injury. Although scientific evidence suggests that Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD) make dementia more likely in service members, such a high service-related rating for dementia may be difficult to obtain unless there is significant documentation. You’ll need to consult with a VA caseworker about your options. These homes may be most likely to accept veterans who have other major service-related physical disability or condition along with dementia.
State Veterans Nursing Homes
After the Civil War, individual states set up nursing homes to meet the enormous need for rehabilitation and long-term care that disabled or homeless veterans from that conflict faced. Many of these state nursing homes are still operating today, now serving veterans of modern conflicts, and they are now called State Veterans Nursing Homes.
In terms of care provided, these facilities are similar to community nursing homes. They offer nursing home care, adult daycare, and domiciliary care. Domiciliary care is simply providing a place to stay for homeless veterans on a temporary or long-term basis. State veterans nursing homes are operated by the states they are located in, but VA officials visit and certify them yearly. It’s possible for a facility to lose its status as a state veteran’s nursing home if it stops meeting VA care standards.
There are state veterans nursing homes in all 50 states, and some states have multiple locations. There’s also a state veteran’s nursing home in Puerto Rico, but not in other U.S. territories.
Homemaker and Home Health Aide Care
In many cases, if the VA assesses that a veteran suffering from dementia needs help with three or more activities of daily living (ADL), they may pay for a community aid agency to send a trained aide to your home. This aide will be trained to help with activities of daily living but will not be able to provide skilled nursing.
Typical tasks an aide helps with:
Moving around within the home
Going to appointments
Eating
Using the bathroom
Bathing
Getting dressed
Personal grooming
Aides from the Homemaker and Home Health Aide Care program will be supervised by a registered nurse who will initially make a plan for the veteran’s daily living needs but will not visit on a regular basis. Aides can visit multiple times a week or just once a week, depending on need. Those without service-related disabilities will usually pay a copay for these services, but all enrolled veterans are eligible as long as they meet clinical need requirements.
Availability for this program is fairly wide, but there still may be some areas without it.
Veteran Directed Home Based Care (VD-HCBS)
Veteran Directed Home Based Care (also called VD-HCBS or just Veteran Directed Care) is an alternative approach to memory care and other healthcare needs that give the veteran and/or caregiver control. In this program, those in need of care sit down with a VA social worker or case manager to set a care budget based on actual needs. Supplies and the need for assistance, including aides, respite care, or even adult daycare, are all part of the budget. The patient has the freedom to select a capable family member to be their paid caregiver, if desired.
Once a budget is approved, any care provider who’s been included in the budget will be paid directly by the VA. Caregivers who purchase supplies included in the budget will be reimbursed from the budget.
This program gives incredible freedom to vets and their loved ones who are dealing with a dementia diagnosis. Receiving these funds gives families the power to make choices that truly suit their needs. This program is not available in all communities, so you will need to check someone from your nearest VA facility to determine if Veteran Directed Care is available to your family.
Aid and Attendance Benefit
Rather than a direct medical program, this benefit includes payments of extra pension funds based on need. If a healthcare team confirms that the veteran’s dementia makes it necessary for them to have aid and attendance to complete activities of daily living such as dressing, bathing, and cooking, then the monthly Aid and Attendance benefit (A&A) may be awarded.
Funds provided by this pension benefit can be used for a range of services. They might be used to pay for rent in an assisted living facility with a memory care unit, for care in a nursing home, medical foster home, or adult daycare, or for an aid who will come to the veteran’s own home. Restrictions may apply, and those who receive this benefit should always consult a VA social worker to make sure you are using funding appropriately.
Pension rates are determined using complex math that involves service history, income, dependents, spouses, medical expenses, assets, and disabilities. Some veterans with a regular VA pension plus the A&A or housebound benefit can receive over $22,000 each year from the VA. Rates are highly specific to the individual, however, and not everyone can qualify.
Another benefit that is separate from but often brought up alongside the A&A benefit is the Housebound Allowance. You will see this benefit mentioned in the link we’ve provided for the A&A benefit. The Housebound Allowance is also additional pension funding that those who already receive the general pension may qualify for. It’s important to note that Veterans cannot receive A&A and Housebound benefits simultaneously; the VA will determine which is the better fit. But if a medical care team can document that a veteran is unable to leave their home, the housebound benefit can be awarded at the same time as the VA pension.
Community Nursing Homes
Community nursing homes are residential medical facilities that include, at a minimum, 24-hour skilled nursing care for minor things like wound care or help with IV medication, occupational and physical therapy for those who need it, and access to social services. Many nursing homes also include their own memory care services, often in distinct units of the facility. Nursing homes may also offer hospice and palliative care, forms of care for the terminally ill that focus on comfort and pain relief rather than on improvement of the underlying condition.
The VA covers the cost of some community nursing home care at facilities that it approves, for those with a clinical need. VA officials routinely visit community nursing locations to verify that facilities are meeting VA care standards. Not all community nursing homes have room for new patients, and a patient may experience a wait time even if they are technically approved for admission.
VA Community Living Centers
VA Community Living Centers used to be called VA Nursing Homes. These community centers provide residential care to veterans at a similar level to that provided by community nursing homes, but they provide it in a more home-like atmosphere. These homes often allow residents to decorate their rooms and keep pets, and they host a variety of stimulating activities for veterans to enjoy.
There are approximately 100 VA Community Living Centers across the nation. Usually, to qualify for long term care at one of these facilities, a veteran needs to have a disability that is deemed to be 60% or 70% caused by a service-related injury. Although scientific evidence suggests that Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD) make dementia more likely in service members, such a high service-related rating for dementia may be difficult to obtain unless there is significant documentation. You’ll need to consult with a VA caseworker about your options. These homes may be most likely to accept veterans who have other major service-related physical disability or condition along with dementia.
State Veterans Nursing Homes
After the Civil War, individual states set up nursing homes to meet the enormous need for rehabilitation and long-term care that disabled or homeless veterans from that conflict faced. Many of these state nursing homes are still operating today, now serving veterans of modern conflicts, and they are now called State Veterans Nursing Homes.
In terms of care provided, these facilities are similar to community nursing homes. They offer nursing home care, adult daycare, and domiciliary care. Domiciliary care is simply providing a place to stay for homeless veterans on a temporary or long-term basis. State veterans nursing homes are operated by the states they are located in, but VA officials visit and certify them yearly. It’s possible for a facility to lose its status as a state veteran’s nursing home if it stops meeting VA care standards.
There are state veterans nursing homes in all 50 states, and some states have multiple locations. There’s also a state veteran’s nursing home in Puerto Rico, but not in other U.S. territories.
Membership opens the door to our personally tailored resources, tools and community designed to empower and assist caregivers.
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