Alzheimer’s and Dementia Home Care in Michigan, Paid by Medicaid

Alzheimer’s and dementia home care in Michigan keeps your loved one in a familiar place with a trained caregiver who handles bathing, dressing, meals, medication reminders, and supervision. Michigan Medicaid pays for it through Home Help when memory loss means your loved one needs hands-on help with at least one daily activity, and a family member can be the paid caregiver.

On this page

1. Does someone with dementia qualify for Home Help in Michigan?
2. What daily care does dementia home care include?
3. How does Medicaid pay for dementia care at home?
4. Can a family member provide this care and get paid?
5. Keeping a person with dementia safe at home
6. Dementia home care across Michigan
7. Frequently asked questions

Does someone with dementia qualify for Home Help in Michigan?

The Home Help program, run by the Michigan Department of Health and Human Services (MDHHS), does not ask what condition a person has. It asks what help they need. That matters for dementia, because a person with Alzheimer’s may be physically capable of bathing or dressing but unable to start the task, follow the steps, or finish safely without someone there.

Hands-on help, reminders and the assessment

At the in-home assessment, an MDHHS adult services worker scores each activity of daily living by the kind of help required. On the state’s scale, a task that needs only reminding or verbal prompting is ranked 2, and a task that needs some hands-on help is ranked 3 or higher. To qualify, your loved one must need help ranked 3 or higher with at least one activity of daily living, and hours are authorized only for tasks at that level. Dementia often gets there: guiding an arm into a sleeve, adjusting the water and washing hair, steadying someone on and off the toilet, or cutting food and helping with each bite. At the assessment, describe the hands-on help, not just the reminders, and describe a hard day rather than a good one.

Home Help does not pay for someone to simply sit with your loved one or for standby supervision. It pays for the tasks. In practice, the caregiver who is there to help with bathing and meals is also there to keep your loved one safe between tasks.

The other requirements

• Enrolled in Michigan Medicaid (apply through MI Bridges if not yet enrolled).
• Lives at home, with family, or in another unlicensed private residence.
• A doctor signs a medical needs form confirming the need for help with daily activities.

Use our free Medicaid eligibility check to see where your loved one stands, and read Home Help and dementia: can a loved one with Alzheimer’s qualify? for tips on documenting needs before the visit.

What daily care does dementia home care include?

Supportive Solutions Homecare caregivers follow a consistent routine, because routine is what a person with memory loss holds onto. A typical care plan covers:

• Personal care with cueing: bathing, dressing, grooming, and toileting, prompted one step at a time.
• Meals: preparing familiar foods, sitting with your loved one to eat, and watching for swallowing problems or weight loss.
• Medication reminders: making sure pills are taken on schedule and not taken twice.
• Safety supervision: preventing falls, wandering, and kitchen accidents during care visits.
• Household tasks: laundry, cleaning, shopping, and keeping the home free of clutter and hazards.
• Engagement: music, photos, simple chores, and conversation that reduce agitation and sundowning.
• Family updates: noting changes in behavior, appetite, or sleep so you can tell the doctor.

How does Medicaid pay for dementia care at home?

Home Help

After the assessment, MDHHS authorizes a monthly number of hours and pays the caregiver directly, whether that caregiver is a family member enrolled through CHAMPS or a Supportive Solutions Homecare employee. Hours can be increased through a reassessment as the disease progresses. See our Michigan Home Help program page for the application steps.

MI Choice Waiver

Middle and late-stage dementia often reaches a nursing-home level of care. At that point the MI Choice Waiver, applied for through your Area Agency on Aging, can add respite care, adult day programs, a personal emergency response system, and home modifications on top of personal care hours. Many families use Home Help first and move to MI Choice as needs grow.

What Medicare does not cover

Medicare pays for short-term skilled nursing or therapy at home after a hospital stay, not for the daily custodial care dementia requires. Families who assume Medicare will cover a caregiver are often surprised; Medicaid Home Help is the program that does.

Can a family member provide this care and get paid?

Yes. Most people with dementia do best with a caregiver they already know, and Michigan Home Help lets the Medicaid recipient choose that person. An adult child, grandchild, sibling, niece, friend, or neighbor can enroll as an individual provider through CHAMPS, pass a background check, and be paid by MDHHS for the authorized hours, logged with Electronic Visit Verification (EVV). Under current MDHHS rules, a spouse or the parent of a minor child generally cannot be paid as the Home Help provider.

If you live with your parent, the payments may qualify as difficulty-of-care payments under IRS Notice 2014-7 and be excludable from federal income tax. We enroll family caregivers and provide dementia care training. Start at become a paid caregiver, and if you need a break, our respite care team can cover you.

Keeping a person with dementia safe at home

Our caregivers do a safety walk-through at the first visit and revisit it as the disease changes. Common steps include:

• Removing loose rugs, adding grab bars, and improving lighting in halls and bathrooms.
• Locking up medications, cleaning products, and sharp tools.
• Installing stove shut-offs and door alarms for wandering.
• Keeping an ID bracelet and a recent photo on hand.
• Posting a simple daily schedule and labeling drawers and doors.

If home is no longer safe even with support, we will say so and help you compare home care, nursing homes, and adult foster care honestly.

Dementia home care across Michigan

Supportive Solutions Homecare provides Alzheimer’s and dementia care at home in Detroit, Dearborn, Warren, Sterling Heights, Ann Arbor, Flint, Lansing, and Grand Rapids, and the surrounding communities. Caregivers are matched by language (English, Arabic or Spanish), because a familiar language calms a person with memory loss.

Frequently asked questions

Can someone with dementia qualify for Home Help in Michigan?

Yes. Home Help eligibility is based on need for help with daily activities, not on a diagnosis. A person with Alzheimer’s or another dementia who must be prompted, cued, or physically helped to bathe, dress, eat, use the toilet, or move safely meets the functional test. They must also be enrolled in Michigan Medicaid and live at home, with family, or in another private residence.

Does Medicaid pay for dementia care at home?

Yes. Michigan Medicaid pays for in-home dementia care through the Home Help program, which funds a caregiver for authorized personal care and household hours. When needs reach a nursing-home level, the MI Choice Waiver adds respite, adult day services, and more. Medicare does not pay for ongoing custodial dementia care at home, only short-term skilled nursing or therapy.

How is dementia scored in a Home Help assessment?

The MDHHS adult services worker ranks each activity of daily living from 1 (independent) to 5 (dependent). Reminding or verbal prompting alone is ranked 2; some hands-on help is ranked 3 or higher. Your loved one needs at least one activity ranked 3 or higher to qualify, and hours are authorized only for tasks at that level. Bring a care log and a doctor’s statement that names the tasks affected.

Can a family member get paid to care for a parent with Alzheimer’s in Michigan?

Yes. If your parent qualifies for Home Help, you can enroll as their individual provider through CHAMPS, pass a background check, and be paid by MDHHS for the authorized hours you log with EVV. Spouses and parents of minor children are generally excluded. If you live with your parent, the payments may be excludable from federal income tax under IRS Notice 2014-7.

What if my loved one with dementia needs 24-hour supervision?

Home Help authorizes hours for specific tasks, not round-the-clock supervision, so it rarely covers a full day. Families usually combine Home Help hours with the MI Choice Waiver, which can add respite and adult day care, plus unpaid family time. If safety at home cannot be maintained even with support, we will talk honestly with you about memory care and adult foster care options.

How do your caregivers handle wandering, agitation, or refusal of care?

Our caregivers are trained in dementia-specific approaches: keeping a consistent routine, using short simple prompts, redirecting instead of arguing, and stepping away briefly when a person refuses a task and trying again later. Wandering is managed with door alarms, ID bracelets, and structured activity. We match caregivers by language and personality because familiarity lowers anxiety for someone with memory loss.