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 October 2026. Education only — not medical, legal or financial advice.
In depth
More in this section
Adult day care
What happens at adult day care, social vs. adult day health care, costs, Medicaid and VA help, how to choose a center, and easing the first weeks.
Read →In-home care
Home care vs. home health, hiring through an agency or on your own, what in-home help costs, and what Medicare will and will not pay for.
Read →Respite care
What respite care is, the main types, how to find it, ways to pay through Medicaid, the VA and Lifespan Respite, and how to take a break without guilt.
Read →Assisted living
What assisted living offers, where it falls short for people with dementia, how Virginia licenses it, what it costs, and who pays.
Read →Memory care
What memory care units offer, Virginia's staffing and training rules, questions to ask, what it costs, how to pay, and signs it may be time to move.
Read →Nursing homes
When a nursing home makes sense in dementia, how Medicare and Medicaid pay, how to read Care Compare stars, visiting, and your loved one's rights.
Read →PACE
How PACE combines a day center, doctors, home care and drugs in one plan, who qualifies, what it costs, the trade-offs, and PACE sites in Virginia.
Read →Choosing a place
How to pick an assisted living, memory care or nursing home for a person with dementia: tour checklist, questions, red flags and inspection reports.
Read →Moving into care
How to tell when it is time, cope with guilt, plan the move day, help your parent settle in over the first weeks, and make visits go well.
Read →