Home Help and Dementia: Can a Loved One With Alzheimer’s Qualify?

Yes. A loved one with Alzheimer’s or another dementia can qualify for Michigan’s Home Help program, which pays for dementia home care, including care from a family member. The key is showing that the person needs hands-on help with at least one daily task like bathing, dressing, eating or toileting, not just that they have a diagnosis.

On this page

1. Can someone with dementia qualify for Home Help?
2. Does supervision count as a qualifying need for dementia home care?
3. What documentation helps a dementia Home Help application?
4. Can a family member get paid for dementia care through Home Help?
5. Which daily tasks does Home Help cover for a person with dementia?
6. Practical tips for caring for a loved one with dementia at home
7. Frequently asked questions

Can someone with dementia qualify for Home Help?

Home Help, run by the Michigan Department of Health and Human Services, does not approve people by diagnosis. It approves them by need. An Adult Services Worker visits the home and scores how much help the person requires with activities of daily living. Anyone with active Medicaid who needs hands-on help with at least one daily activity can qualify, and dementia produces exactly that kind of need.

A person in the early stages may only need medication reminders and help with shopping. By the middle stages, most people need physical help, not just reminders, to bathe, dress, eat enough and use the toilet safely. That hands-on help is what Home Help pays for. Our guide to who qualifies for Home Help in Michigan lists the full eligibility rules.

Does supervision count as a qualifying need for dementia home care?

This is where families get confused, so it is worth being precise. Home Help pays for tasks, not for time spent watching someone. Sitting with your father so he does not wander is not, by itself, a paid Home Help service. But dementia care is rarely just watching.

What does count

• Hands-on help with dressing: guiding her arms into the sleeves and doing up buttons, not only telling her each step.
• Hands-on help: physically assisting with bathing because she resists or forgets how.
• Setting up and handing over medication so it is not skipped or doubled.
• Preparing meals and sitting with her to make sure she eats.
• Toileting help and incontinence care.
• Guiding her safely from room to room or in and out of a chair.

On the assessment scale, a task that needs only reminding or verbal prompting is ranked 2, below the level Home Help pays for. Your loved one needs at least one daily activity that requires hands-on help (rank 3 or higher) to qualify, and hours are approved only for tasks that reach that level. Describe what actually happens on a hard day, because with dementia the hard days are the ones that matter.

If your loved one needs near-constant supervision beyond what task-based hours cover, the MI Choice Waiver is the next step. It funds adult day programs, respite and more for people at a nursing-facility level of care.

What documentation helps a dementia Home Help application?

1. The Medical Needs form. A physician, physician assistant or nurse practitioner confirms the diagnosis and the need for help with daily activities. Ask the doctor to name the specific tasks affected, not just write “dementia.”
2. A two-week care log. Note every time you helped with bathing, dressing, meals, toileting, medication or moving around, and how long it took. Bring it to the assessment.
3. Cognitive test results. A recent MMSE, MoCA or neurologist’s note shows the stage of the disease.
4. Safety incidents. Falls, a burner left on, a missed medication, or wandering outside all show why help is needed.
5. Active Medicaid. Confirm coverage first with our Medicaid eligibility check.

Read our walkthrough of what happens at the Home Help assessment visit so you know what the worker will ask.

Can a family member get paid for dementia care through Home Help?

Yes. The person with dementia, or their representative, chooses the caregiver. Adult children, grandchildren, siblings, other relatives and friends can enroll as individual providers through CHAMPS after a background check. No certification is required. A spouse cannot be paid as a Home Help provider, and legal guardians face extra restrictions, so if you are the husband or wife, ask about the MI Choice Waiver as well.

The caregiver is paid an hourly rate set by MDHHS for the approved monthly hours and logs each visit through electronic visit verification. If a relative already lives with the person and provides the care, IRS Notice 2014-7 may allow the pay to be excluded from federal income tax. Learn how to become a paid caregiver for someone you already care for.

For families who need trained backup, Supportive Solutions Homecare provides Alzheimer’s and dementia care at home with aides trained in redirection, routine and safe bathing, in Detroit, Dearborn, Warren, Sterling Heights, Ann Arbor, Flint, Lansing and Grand Rapids. A family caregiver and an agency aide can share the approved hours.

Which daily tasks does Home Help cover for a person with dementia?

Task	What dementia care often looks like
Bathing	Setting water temperature, cueing each step, hands-on washing, staying close for safety
Dressing and grooming	Laying out clothes in order, help with buttons and shoes, brushing hair and teeth
Eating and meal preparation	Cooking, cutting food, reminding to eat, watching for choking
Toileting	Scheduled bathroom trips, cleanup, changing protective garments
Medication	Filling a pill organizer, handing doses at set times
Mobility and transfers	Guiding walking, help in and out of bed and chairs
Shopping, laundry, housework	Errands and chores the person can no longer manage safely

Practical tips for caring for a loved one with dementia at home

• Keep a steady routine. Same wake time, meals and bath time reduce anxiety and refusals.
• Simplify choices. Offer two outfits, not a closet.
• Do not argue with a false belief. Redirect to a pleasant activity instead.
• Make the home safer. Remove rugs, add night lights, lock away medications and chemicals, and consider a door alarm.
• Plan for respite early. A second Home Help provider or an adult day program keeps the main caregiver healthy. See our post on who pays for respite care in Michigan.
• Reassess as the disease progresses. Ask MDHHS for a new assessment whenever needs increase, rather than waiting for the annual review.

Frequently asked questions

Can someone with dementia qualify for Home Help?

Yes. Home Help approves people based on functional need, and dementia typically creates a need for hands-on help with bathing, dressing, eating or toileting. The person must have active Michigan Medicaid and a Medical Needs form from a doctor. Hours depend on how many daily tasks require help and how long each takes.

Does Medicaid pay for dementia care at home?

Yes. Michigan Medicaid pays for in-home dementia care through Home Help, which funds a caregiver for approved monthly hours, and through the MI Choice Waiver, which adds respite, adult day care and other supports for people who need nursing-facility level care. Medicare does not pay for ongoing dementia home care, only short-term skilled visits.

My husband has dementia. What kind of help can I get?

Start with a Home Help assessment through your county MDHHS office to fund daily care hours. Ask the Area Agency on Aging about the MI Choice Waiver and caregiver respite programs. The Alzheimer’s Association helpline can connect you to support groups and local services. A spouse cannot be paid as a Home Help provider, so ask the MI Choice waiver agent what options apply to you.

Can dementia patients be taken care of at home?

Most can, often for years, with the right support. A predictable routine, a safe home, help with daily tasks, and regular breaks for the caregiver make home care workable through the middle stages and sometimes beyond. Medicaid Home Help and the MI Choice Waiver exist to fund exactly this kind of care so families are not doing it alone.

Does Medicare pay for dementia care at home?

Only in a limited way. Medicare covers short-term skilled nursing or therapy at home after an illness or hospital stay, and doctor visits, but it does not pay for the ongoing personal care a person with dementia needs. That long-term care is a Medicaid benefit in Michigan, so checking Medicaid eligibility is the most important first step.