Caring for Someone with Dementia
If someone you love has been diagnosed with dementia or Alzheimer's disease, you're already doing one of the hardest things a person can do. This guide is here to help you make their home safer, find the right equipment, understand what insurance covers, and — just as importantly — take care of yourself.
You don't have to figure this out alone.
In this guide:
1 Making the Home Safe
As dementia progresses, the home becomes the front line of safety. Small changes now can prevent serious falls, wandering episodes, and medication accidents later. Here's a room-by-room breakdown.
🚪 Entry & Doors — Wandering Prevention
Wandering is one of the biggest safety risks in dementia. 6 in 10 people with dementia will wander at some point. Many wander at night.
- 🔔 Door alarms: Simple chimes or alarms that sound when an exterior door opens. Look for options that plug into a standard outlet. Test them weekly.
- 🔒 Deadbolt covers or door knob covers: Requires two-step operation to open. Can prevent a person from leaving without fully understanding how.
- 🎨 Visual camouflage: A full-length mirror placed over a door can reduce attempts to exit (some people with dementia won't approach their own reflection). Large "STOP" signs or decorative murals over doors can also work.
- 📍 GPS tracking wearables: Discreet GPS devices worn on the wrist, ankle, or clipped to clothing. Brands like AngelSense, LifeStation GPS, and Apple Watch (with family sharing) allow real-time location tracking.
- 🪪 MedicAlert + Alzheimer's Association Safe Return: A low-cost registry and ID bracelet ($50/year) that connects with emergency responders nationwide if your loved one is found away from home.
🍳 Kitchen — Fire & Stove Safety
Stove knob covers
Plastic covers that require a pinch-and-turn motion to operate. Prevent the stove from being turned on accidentally.
Automatic stove shut-off
Devices like Stove Guard or iGuard Stove detect when someone has been in the kitchen without returning and shut off the burners.
Remove or lock knives
Store sharp utensils in a locked drawer. Consider foam-handled adaptive utensils for meals.
Childproof cabinet locks
Lock cabinets containing cleaning supplies, alcohol, vitamins, and any medications stored in the kitchen.
Automatic kettle shut-off
Use an electric kettle that turns off automatically after boiling. Prevent burn injuries from forgotten stovetop pots.
Label the microwave
A simple laminated card above the microwave with step-by-step instructions can extend independent use safely in early stages.
🛁 Bathroom — Fall Prevention
Grab bars in shower & by toilet
Professionally installed grab bars (not suction-cup versions) are the most effective fall prevention tool. Install on the wall next to the toilet and inside the shower.
Non-slip bath mat
Both inside and outside the tub or shower. Replace annually — they lose grip over time.
Raised toilet seat
Makes it easier to sit and stand. Reduces fall risk during toileting. Many clip onto existing toilets without tools.
Tub bench or shower chair
Allows bathing while seated, dramatically reducing fall risk. Look for models with a back and adjustable legs.
Anti-scald faucet
Set water heater to 120°F (49°C). A person with dementia may not reliably test water temperature before stepping in.
Automatic night light
Motion-activated lights between the bedroom and bathroom. Many bathroom falls happen at night.
🏠 Throughout the Home — General Safety
💊 Medication Management
Medication errors are a leading cause of hospitalizations in dementia patients. A missed dose, double dose, or wrong medication can trigger serious health crises.
Locked Medication Lockbox
Keep all medications locked. Fill the weekly pill organizer yourself, then lock it until each dose is needed.
Automatic Pill Dispenser
Devices like Hero or MedMinder dispense the right pills at the right time with audio/visual alarms. Some alert caregivers if a dose is missed.
2 Equipment & Assistive Devices
Check off items as you acquire them. This list covers what most families caring for someone with dementia at home will need — from early to late stage.
Find Suppliers for These Items Near You
Search local Medicare-certified DME suppliers for grab bars, walkers, hospital beds, and more.
Find Home Safety & Mobility Suppliers →3 Understanding the Stages
Dementia typically progresses through three broad stages. Knowing what to expect — and when to change your approach — helps you plan ahead rather than react to crises.
Early Stage (Mild Dementia)
Typically 2–4 years, but varies widely
What you'll see
- • Forgets recent conversations, appointments
- • Gets lost in familiar places
- • Struggles with bills, managing money
- • Mood changes, withdrawal
- • Can still live semi-independently
Key equipment
- • Automatic pill dispenser
- • Large-face day/date clock
- • Medical ID bracelet or GPS wearable
- • Simple labeled phone
Care level
With supervision and prompting
Middle Stage (Moderate Dementia)
Typically 2–10 years — the longest and most demanding stage
What you'll see
- • Needs help with bathing, dressing, toileting
- • Wandering, especially at night
- • Personality and behavior changes
- • May not recognize family members
- • Increased fall risk
Key equipment
- • Door alarms, GPS tracker
- • Grab bars, shower chair
- • Walker or rollator
- • Bed rails
- • Incontinence supplies
Care level
Evaluate adult day programs & respite care
Late Stage (Severe Dementia)
Typically 1–3 years
What you'll see
- • Fully dependent for all care
- • Limited or no verbal communication
- • Difficulty swallowing, weight loss
- • Bedridden or mostly immobile
- • Increased infection risk
Key equipment
- • Hospital bed with side rails
- • Pressure-relief mattress
- • Lift chair or patient lift
- • Wheelchair
- • Incontinence supplies
- • Oral care / feeding supplies
Care level
Home hospice is often an option
4 What Insurance Covers
The honest truth:
Medicare has significant gaps in dementia care coverage. Knowing what IS and ISN'T covered helps you plan financially and find alternative resources before you need them.
✅ What Medicare Covers
Skilled Home Health (Part A/B)
Medicare covers skilled nursing visits, physical therapy, occupational therapy, and speech therapy when ordered by a doctor and provided by a Medicare-certified home health agency. Must be "medically necessary" and "skilled."
Durable Medical Equipment (Part B)
Hospital beds, wheelchairs, walkers, bed rails, and other equipment prescribed by a doctor. You pay 20% after your Part B deductible. Medicare Advantage plans may cover more.
Cognitive Assessment (Part B)
Medicare covers an annual wellness visit that includes a cognitive assessment. Early detection can help with care planning and legal affairs.
Hospice Benefit (Part A)
When dementia has progressed to terminal stage with a 6-month or less prognosis, Medicare Hospice covers nursing, aides, medications, and equipment at no cost. Home or facility.
Inpatient Hospital (Part A)
Medicare covers hospital stays for acute conditions — pneumonia, fractures, falls. Does NOT cover long-term care or memory care facility stays.
Prescription Drugs (Part D)
Medications to manage dementia symptoms (like cholinesterase inhibitors or memantine) are covered under Part D drug plans.
❌ What Medicare Does NOT Cover
- Custodial care — personal care help with bathing, dressing, toileting, and feeding is NOT covered unless delivered alongside a skilled service
- 24/7 supervision or companion care — continuous in-home supervision is not a skilled service and is not covered
- Memory care facility costs — room and board at an assisted living memory care facility is not covered by Medicare
- Adult day programs — Medicaid, VA benefits, or out-of-pocket; some Medicare Advantage plans offer limited supplemental benefits
- Home safety modifications — grab bars, door alarms, non-slip mats, GPS trackers are generally not covered (some MA plans include home safety benefits)
- Respite care — Medicare only covers inpatient respite (up to 5 days) under the Hospice Benefit; not for general respite
💡 Other Ways to Pay for Care
Medicaid
For those who qualify (income/asset limits), Medicaid covers long-term custodial care — including memory care facilities and in-home personal care aides. Contact your state Medicaid office.
VA Benefits
Veterans may qualify for Aid & Attendance benefits that help pay for in-home care, assisted living, or nursing home care. Call 1-800-827-1000.
Long-Term Care Insurance
If purchased before diagnosis, LTCi policies cover custodial care. Check the policy's dementia benefit trigger and waiting period.
Area Agency on Aging
Local Area Agencies on Aging (eldercare.acl.gov) administer free and low-cost programs including in-home assistance, meals, and respite care for caregivers.
5 Caregiver Support
You cannot pour from an empty cup. Caregiver burnout is real, it is common, and it quietly increases the risk of harm — both to the person you're caring for and to yourself. The most important thing you can do for your loved one is take care of yourself.
⚠️ Signs of Caregiver Burnout
If you're experiencing any of these, please reach out for help. This is not weakness — it's the predictable result of an incredibly hard situation without enough support.
🌿 Respite Care Options
Adult Day Programs
Structured, safe programs that provide supervision, activities, and meals for 4–8 hours during the day. Some are dementia-specific. Cost: $25–$100/day; Medicaid and some programs offer sliding scale.
Eldercare Locator: 1-800-677-1116
In-Home Respite Workers
A trained aide stays with your loved one at home for a few hours or days so you can rest, run errands, or sleep. Available through home health agencies or volunteer programs.
ARCH Respite: archrespite.org
Short-Term Facility Stays
Some memory care and skilled nursing facilities offer short-term respite stays (1–4 weeks). Medicare Hospice covers up to 5 days inpatient respite per period if on hospice.
Ask your local Area Agency on Aging
🤝 Support Groups
Dementia caregiving can be deeply isolating. Support groups — online or in person — connect you with people who understand what you're going through. Many families say it's the most helpful thing they did.
Alzheimer's Association 24/7 Helpline — 800-272-3900
Free online community and in-person groups by state. Caregiver-specific and diagnosis-specific groups available. Call anytime — day or night.
Family Caregiver Alliance — 800-445-8106
Education, webinars, individual consultations, and state-specific resource guides. Specialists available weekdays.
AARP Caregiver Support Line — 877-333-5885
Free counseling and referrals for caregivers. Available 7am–11pm ET Monday–Friday.
Memory Café (ask your hospice or home health team)
Social gatherings for people with dementia AND their caregivers to attend together in a welcoming environment. Ask your care coordinator to find one near you.
⚖️ Legal Planning — Do This Early
Legal planning must happen while your loved one still has the capacity to participate. Once dementia has progressed significantly, it may be too late to execute certain documents.
Durable Power of Attorney (POA)
Designates someone to make financial and legal decisions when the person can no longer do so. Without this, you may need costly court guardianship.
Healthcare Proxy / Medical POA
Designates someone to make healthcare decisions. Different from financial POA — both are needed.
Advance Directive / Living Will
Documents the person's wishes for end-of-life care — ventilators, feeding tubes, CPR, hospice. Reduces family conflict during the hardest moments.
POLST / MOLST Form
A medical order (signed by a doctor) that travels with the person and tells emergency responders what care they do and do not want. More actionable than an advance directive.
Local elder law attorneys can prepare these documents. Many legal aid organizations offer free or low-cost help for qualifying families.
🏥 When to Consider a Memory Care Facility
Moving a loved one to a memory care facility is never easy. But sometimes it is the most loving decision you can make — for them and for yourself. Consider it when:
- Wandering is frequent and your home cannot be made safe
- Aggressive behavior puts your loved one or others at risk
- Your loved one needs 24/7 supervision that you cannot provide
- You are experiencing serious health problems from caregiving
- A major fall or health event has made home care unsafe
- The person no longer recognizes home and is more agitated there than in a care environment
Choosing a memory care facility is not giving up — it is recognizing that your loved one's needs have grown beyond what home care can safely provide. Many families find that their relationship with their loved one actually improves once they are no longer the primary hands-on caregiver.
📞 Key Hotlines & Resources
6 Printable Caregiver Checklist
A one-page summary of what to address. Print it, share it with family, bring it to your doctor.
Dementia Home Care Checklist
DMEHelper.com — Use this checklist to organize care and track what's been done.
DMEHelper.com/care-guides/dementia — Free to print and share. For informational purposes only. Consult your healthcare team for medical decisions.
Have a Question? Ask Dottie
Dottie can help you find Medicare-certified DME suppliers near you, explain what your insurance covers, and guide you to the right resources for your specific situation.