The first 30 days

You are not alone, and you do not have to do all of this this week. About 7.4 million Americans aged 65 and over are living with Alzheimer’s in 2026, and nearly 13 million people give unpaid care to someone with dementia. Here is what matters first.

The first 30 days, step by step

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Medical: weeks 1 to 2

Confirm the diagnosis Ask which type of dementia this is, and what stage.Alzheimer’s is the most common type, but not the only one. The page on what Alzheimer’s is explains the types. Book the Medicare cognitive assessment and care plan visit (CPT code 99483).About 60 minutes with your parent and a family member: a memory exam, a check of daily function, staging, a review of high-risk medicines, behavior, home and driving safety, and a written care plan. A doctor, nurse practitioner, physician assistant or clinical nurse specialist can do it, in the office, at home or by video. Ask which treatable causes were ruled out.Medicine side effects, thyroid, kidney or liver problems, low vitamin B12, depression, anxiety, sleep problems, alcohol or drug misuse, head injury, and clots, tumors or infections in the brain can all cause or worsen memory trouble. See getting a diagnosis.

Medicines and treatment Bring every pill bottle to the visit, including vitamins, supplements and over-the-counter sleep and allergy aids.The American Geriatrics Society’s Beers Criteria flag sleeping pills such as lorazepam and “Z-drugs”, and strongly anticholinergic drugs such as diphenhydramine (Benadryl), some bladder pills and older antidepressants, as causes of confusion in older adults. Never stop a prescribed drug on your own; ask the doctor or pharmacist. Ask whether the newer anti-amyloid drugs or a clinical trial fit her stage.Medicare covers lecanemab (Leqembi) and donanemab (Kisunla) when amyloid is confirmed and the doctor enters data in a national registry. See the medicines page and clinical trials.

Family and legal: weeks 1 to 4

Talk early Tell close family, and start the planning conversations now, while your parent can take part. Gather important papers in one place, and tell the family where they are.

Sign while she still has legal capacity Durable power of attorney for finances.“Durable” means it stays valid after she can no longer decide for herself. Durable power of attorney for health care (also called a health care proxy). Living will or advance directive.Her wishes about life support and end-of-life care. It can include a do-not-resuscitate (DNR) or do-not-intubate (DNI) choice. Ask the doctor about a POLST or MOLST form.These are state-specific medical orders for serious illness, more detailed than a DNR, filled in with her doctor. A will, and possibly a living trust. Find an elder-law attorney.Try your state bar’s referral service, the National Academy of Elder Law Attorneys (NAELA) directory, or LawHelp.org. Give copies to every doctor, and update them as things change.

If these papers are never signed and she loses capacity, the family has to go to court for guardianship or conservatorship. That is slower and costlier, and the rules vary by state. The Alzheimer’s Association guide to legal documents explains each one.

Money protection: weeks 2 to 4

Watch the accounts Have one trusted person review her bank and card statements. Watch for unusual withdrawals, new “friends”, gift-card purchases and requests to wire money. Ask her bank what protections it offers for customers with memory loss.

Trouble spotting scams can show up early in Alzheimer’s, sometimes before memory problems are obvious. Harvard Health summarizes the research on scams and early Alzheimer’s.

About 6 in 10 people with dementia will wander at least once, and many do it again. People who wander are usually found within about 1.5 miles. The Alzheimer’s Association wandering guide has more. For guns, the Family Caregiver Alliance guide to guns and dementia includes a written “firearm retirement” agreement. If anyone is in immediate danger, call 911.

Paying for care

This is the part that surprises most families. Health and long-term care for people with dementia in the US is projected to cost $409 billion in 2026, and much of it falls on families.

What Medicare does and does not pay for

Does not pay: long-term custodial care, which means help with bathing, dressing, eating and supervision. Medigap supplement plans do not pay for it either.
Skilled nursing facility, short term only: after a hospital stay of at least 3 days as an admitted inpatient (“observation” days do not count), when she needs daily skilled care. Up to 100 days per benefit period. In 2026, days 1 to 20 cost $0 after the $1,736 deductible; days 21 to 100 cost $217 a day; from day 101 you pay everything.
Home health: only if she is homebound and needs part-time skilled care. It does not cover 24-hour care, housekeeping, or personal care when that is the only need.
Does pay: the care-planning visit (code 99483), and hospice in the final months (see the living with it page).

The CMS GUIDE Model

GUIDE is a Medicare program for dementia care, launched on 1 July 2024 and set to run for 8 years. Taking part is voluntary for both families and care organizations. It offers a care navigator, a 24/7 support line, caregiver training, connection to local services, and up to $2,500 a year for respite (a break for the caregiver) at home, at adult day care or in a short facility stay. As of August 2026 it was active with 292 participating organizations. Check the CMS GUIDE Model page for the participant list and map, and ask one of them whether your parent qualifies.

Medicaid

Medicaid is run jointly by the federal government and each state. Most nursing homes accept it, though not all. Many people pay privately at first, use up their savings (“spend down”), and then qualify. Before a move, check that the nursing home accepts Medicaid.

Medicaid “waivers” (Home and Community-Based Services, 1915(c)) can pay for help at home: case management, homemakers, home health aides, personal care, adult day health and respite. They are for people who would otherwise qualify for nursing-home care. States cap the number of places, so many have waiting lists. Medicaid rules are complex; an elder-law attorney can help plan.

VA benefits

If your parent is a veteran or a veteran’s surviving spouse, Aid and Attendance adds money to a VA pension for someone who needs help with daily activities such as bathing, feeding and dressing, is bedridden, or lives in a nursing home because of disability. You can apply online, by mail (VA Form 21-2680) or at a regional office. Nursing home residents also file VA Form 21-0779. See the VA Aid and Attendance page for current rates.

Long-term care insurance

If she has a long-term care policy, read it now. Some cover only nursing homes. Others also pay for adult day care, assisted living, equipment and informal help at home. Check the limits and exclusions. Some life insurance policies can also be used to pay for long-term care.

What care costs

What care costs in the USNational medians, CareScout (Genworth) Cost of Care Survey, 2025.
Type of care	Median cost	Per year
Home care aideNon-medical help at home	$35 / hour	about $80,080 at 44 hours a week
Skilled nursing at home	$90 / hour	depends on hours
Adult day health care	$95 / day	depends on days
Assisted living	$6,200 / month	$74,400
Nursing homeShared room	$315 / day	$114,975
Nursing homePrivate room	$355 / day	$129,575

Local prices vary widely. Memory care is not a separate line in this survey. Look up your area on the CareScout cost of care survey.

Care settings compared

Where care can happenWho each setting suits and who usually pays.
Setting	Best for	Who usually pays
Home, with family and paid help	Early and middle stages, with strong family support	Private pay, Medicaid waiver, long-term care insurance, VA
Adult day center	Someone living at home whose caregiver works or needs daytime breaks	Private pay (sliding scales are common), Medicaid in some states, GUIDE respite
Assisted living	Needs help with some daily tasks but not 24-hour nursing	Mostly private, some Medicaid waivers, long-term care insurance
Memory careA dementia unit in assisted living or a nursing home	Wandering, needing a secure setting and dementia-trained staff	Mostly private
Nursing home	24-hour supervision and skilled care	Private, then Medicaid; Medicare only for short-term rehab
HospiceAt home, in assisted living or in a nursing home	The final months, with comfort as the goal	Medicare Part A (not room and board)

Adult day centers usually run 7 to 10 hours a day, with activities, meals and some health services. It often takes a few weeks to settle in. When you visit any center or home, ask about staff dementia training, emergency procedures, transport, fees and extra charges, and which health professionals are on staff.

Helplines

Talk to someone now

Free, confidential, and answered by trained staff. The numbers are plain text, so you can copy them.

Alzheimer’s Association Helpline
1-800-272-390024 hours a day, 7 days a week · 200+ languages · TRS 711
988 Suicide & Crisis Lifeline (for you, the caregiver)
988Call or text 988, any hour · free and confidential · for anyone overwhelmed, hopeless or in emotional crisis, not only suicide
Alzheimer’s Foundation of America Helpline
1-866-232-8484Licensed social workers · 9am to 9pm Eastern, 7 days a week · text 646-586-5283
Eldercare Locator (local services)
1-800-677-1116Finds her local Area Agency on Aging for in-home help, meals and respite
MedicAlert Safe & Found (wandering emergencies)
1-800-432-537824-hour emergency line for enrolled members

The Alzheimer’s Association line is staffed by master’s-level care consultants who can help with what the diagnosis means, care planning, behavior changes, legal and money questions, and local referrals. For legal and Medicaid planning, look for an elder-law attorney through NAELA, your state bar or LawHelp.org.

Words used on this page

Custodial care: Help with everyday living, such as bathing, dressing, eating and supervision, rather than medical care. Medicare does not pay for it long term.
Respite: Short-term care that gives the main caregiver a break.
Legal capacity: Being able to understand a document and its effects well enough to sign it.
POLST / MOLST: Physician (or Medical) Orders for Life-Sustaining Treatment: a state form, signed with the doctor, that turns end-of-life wishes into medical orders.