The Right Connection - Dementia Services

A first step is to have the person suspected of having dementia checked out by a qualified physician. The doctor can determine what, if anything, is actually wrong and recommend treatment. If the doctor’s diagnosis is dementia, further legal steps to provide that person with adequate legal protections are necessary. 

It is important to have the doctor specify in detail, as clearly as possible, exactly what the person is capable of doing from a decision-making standpoint when the diagnosis is made. For example, can the person identify and understand the extent of the property s/he owns and who his/her heirs are? Is s/he capable of understanding the nature of a transaction sufficient to enter into a contract? Can s/he identify those who s/he trusts enough to manage his affairs in order to authorize them to do so? 

If the answer to any of the above questions is “yes” then consult an elder and estate planning attorney in order to put that person’s legal affairs in order with documents such as Powers of Attorney for financial and medical affairs, wills, trusts, and any other documents which apply to his particular circumstances. By doing this, you can keep that person’s life private and reduce legal fees and court costs.  

If the answer to the any of those questions is “no” it may be necessary to go into probate court and petition for a Guardianship and Conservatorship in order to take over management of that person’s personal and financial affairs. This is an expensive, public process that requires ongoing court supervision. This scenario will often occur once a person with dementia progresses to later stages and no longer has the capacity to enter into legal documents that would eliminate the need for a guardianship or conservatorship.  This is another reason for consulting a physician and an elder and estate planning attorney as early as possible. It is strongly recommended to have legal documents in place that provide others with authority to act on one’s behalf well before dementia or any other incapacitating condition occurs.

Pamphlets, fact sheets, videos, books, etc. on dementia are available from:

Support groups for persons with early stage Alzheimer’s Disease is available at SarahCare Adult Day Services, 13425 Nineteen Mile Road, Suite 500, Sterling Heights, MI 48313 on the second Wednesday of the month from 6:00 -7:00 P.M. A pre-assessment is required, call (800) 272-3900,  TTY: (877) 204-6924.

Support groups for persons with Alzheimer's disease and their caregivers:

Pamphlets, fact sheets, videos, books, etc. on dementia are available from:

Counseling for older adults experiencing family, social, or emotional problems is available from:     

In a mental health emergency, call the Macomb County Crisis Center, (586) 307-9100 or (855) 996-2264 (Toll free). The client will be directed to either services through the Community Mental Health network or to the nearest Emergency Room. 

At the hospital, staff will assess the immediate need and obtain authorization for the appropriate level of care. Treatment may be provided in an inpatient unit or in an alternative community setting, according to best practice guidelines, Macomb County Community Mental Health or hospital policy, and the situation. 

Mental Health Assessment Services are available for persons through Macomb County Community Mental Health - outpatient sites. Services include: assessment of the problem, insurance, and referrals to an appropriate agency, based on needed level of care, type of insurance and location of service.  Macomb County Community Mental Health receives referrals through its Access Center.  

Agencies are asked to contact the CMH Access Center to discuss service responsibilities prior to referring the consumer. Provider line to the Access Center: (586) 948-0206.

A program of services (personal care, homemaking, respite, adult daycare, transportation, home-delivered meals, counseling, medical equipment and supplies) for eligible Medicaid recipients (18 years or older with a disability, and who medically qualify for nursing home admission (e.g., personal care, respite, medical supplies and equipment) to assist frail adults to remain living independently. (This service may have a waiting list).  For more information about the MI-Choice program, call:     

Free to low-cost medical services including treatment for acute illnesses (colds, ear infections, bronchitis, rashes, cuts); women's health (gynecological physicals, family planning, sexually-transmitted-diseases); treatment for chronic illnesses (high blood pressure, diabetes); employment and school physicals: referrals to other services.  Service is available for persons and families of all ages, economically disadvantaged, persons with no medical insurance.  Available from:

Assistance with locating programs which help with prescription drug costs is available from a number of community resources.  For a referral to these programs or eligibility criteria, contact:  

A search engine designed to help patients, caregivers and health care providers learn more about the resources available through the various biopharmaceutical industry programs. MAT is not its own patient assistance program, but rather a search engine for many of the patient assistance resources that the biopharmaceutical industry offers. https://medicineassistancetool.org/ 

Recipients of Medicare from Social Security can enroll in Medicare Part D (prescription drug benefit). Low income persons below 150% of poverty can receive “extra help” from Social Security, (800) 772-1213, at a reduced or no premium.  For advice about which provider to choose, call the Area Agency on Aging - Medicare/Medicaid Assistance Program, (800) 803-7174 or the Department of Senior Services (586) 469-5228 or Social Security (800) MEDICARE (800) 633-4227, or see www.medicare.gov

Prescriptions mailed to your home for persons in Macomb County age 18 and older who do not have prescription drug coverage and earn $21,780 or less per year (individual) or earn $29,420 or less per year for a couple (add $300 per dependent) - and not currently enrolled in Medicaid.  Prescriptions are mailed to your home.  There is an $8.30 co-pay per prescription.  Call for an application and information.  Available from World Medical Relief, (313) 866-5333.  E-mail:  info@worldmedicalrelief.org/local-programs.  Website:  http://www.worldmedicalrelief.org/

Prescriptions for veterans with a service-connected disability (if unsure of eligibility, contact the Health Benefits Department) is available from Veterans Administration Benefits through the Detroit VA Medical Center, (800) 511-8056.

A ninety (90) day supply of 125 medicines for $20, $30 or $40.  Often prescription drugs not available in other programs are included here.  Available from Rx Outreach, (800) 769-3880.  Website:  http://www.rxoutreach.com

Free medical care and medications to low-income, uninsured persons is available from the Medical Outreach Clinic. Website: https://www.mclaren.org/main/macomb-medical-outreach-clinic 

A free online directory of organizations that loan home medical equipment for free or at low-cost is available from the Great Lakes Loan Closet, www.LoanClosets.org

Free loan of medical equipment such as walkers, wheelchairs, crutches, three-pronged canes, tub seats, etc. to senior citizens aged 60 and older is available from Office of Senior Services, (586) 469-5228.

Loan closets of medical equipment (wheelchairs, canes, crutches) are sometimes available at fire departments, city offices, and fraternal orders.  Contact those organizations in your community.   Also referrals  to loan closets and durable medical equipment suppliers are available from the Area Agency on Aging 1-B, (800) 852-7795.

A free online directory of organizations that loan home medical equipment for  free or at low-cost. Available at www.LoanClosets.org

Mass transit for citizens by SMART bus services. Exact fare tickets and monthly (unlimited rides) cards may be purchased through SMART or at participating banks and select outlets.  Aides on duty with persons with dementia ride FREE (must be ADA Certified).  For more information call Suburban Mobility Authority for Regional Transportation (SMART), (866) 962-5515.  Website:  www.smartbus.org

Transportation for income-eligible residents to essential locations such as hospitals, doctor's offices, DHS, etc.  Rides must be scheduled in advance. Available from Macomb Community Action Centers:

An emergency response system for persons who may fall or need emergency assistance in their home involving the installation of a system to the telephone. The client wears a neck pendant or wrist band with a button that can be pushed.  When the button is depressed, a network operator speaks to the client over a loud speaker attached to the telephone. If there is no response, their contact person is immediately notified.  An emergency response system is available to all persons from (prices subject to change):

Adult day care and activity services for Macomb County residents aged 55 and older with physical, mental/emotional impairments or social isolation are available from the following Macomb County centers:

FOR A LIST OF ADULT CARE CENTERS IN COMMUNITIES SURROUNDING MACOMB COUNTY, CALL THE OFFICE OF SENIOR SERVICES, (586) 469-5228, THE ALZHEIMER’S ASSOCIATION AT (248) 272-3900 OR THE AREA AGENCY ON AGING 1-B, (800) 852-7795.

A program of services (personal care, homemaking, respite, adult day care, transportation, home-delivered meals, counseling, medical equipment and supplies) for eligible Medicaid recipients (18 years and older with a disability, and who medically qualify for nursing home admission, e.g., personal care, respite, medical supplies and equipment) to assist frail adults to remain living independently. (This service may have a waiting list.) For more information about the MI-Choice Program, call:    

Immediate short-term homemaking and personal care assistance for persons 60 years or older following a hospitalization. Available from the Area Agency on Aging, 1-B (800) 852-7795 and ask to speak to the Community Living Program.  

Assistance with all activities of family living for elderly or disabled adults who are eligible for Medicaid.  Available from the Department of Health and Human Services Home Help program:

Homemaking services are available from:

Legal Hotline for Older Michiganians: (800) 347-5297

Michigan Law for  Everyone by Sherry A. Wells, J.D. is a book which provides information on landlord-tenant, contracts, real estate, divorce, juvenile law, guardianships, insurance, accidents, unemployment, small claims courts, wills and probate, business law, workers compensation, how to find an attorney, attorney fees, examples of laws and legal forms. Available at bookstores.

Free or minimal cost legal advice by telephone provides legal advice except for traffic violations or misdemeanors. Available from Legal Aid and Defender Association in Wayne County, with an office in Macomb County.  Toll-free number:  (877) 964-4700.

Referral to area legal resources including elder law attorneys is available from the Alzheimer’s Association, (800) 272-3900.

Referrals to attorneys who practice elder law is available from Macomb County Bar Association (586) 468-8300.           

Referrals for legal assistance for older adults is available from the Area Agency on Aging 1-B, (800) 852-7795.

Small group instruction or one-time presentation on basic nutrition, food buying and preparation skills, meal planning and budgeting - EFNEP  is for limited-resource adults who are responsible for planning, shopping and preparing food for children in their household, individuals and families who are expecting a child or adults who care for children on a regular basis (grandparents). Available from the MSU Extension - Expanded Food Nutrition Educational Program (EFNEP), (469) 469-5816.             

Emergency Food is available through various food pantries in Macomb County.  The criteria to access the Macomb Food Program requires only that a person be a Macomb County resident and have an emergency need for food.  The person in need of emergency food must call United Way information/referral 2-1-1 or (800) 552-1183.

Congregate Meal sites are available around Macomb County, for more information call the Office of Senior Services, (586) 469-5228.            

Home-delivered meals are available for seniors unable to leave their home.  For more information call the Office of Senior Services, (586) 469-5228.

Relief breaks for full-time family caregivers of elderly or disabled adults, excluding personal care, from volunteers matched with families throughout Macomb County is available from Macomb County Interfaith Volunteer Caregivers,  (586) 757-5551.  Office hours Monday - Thursday 9:00 AM - 4:00 PM.  Office is closed on Fridays, Weekends, and Holidays.

Twenty four (24) hour caregiver in a licensed foster care home twice a year for up to two weeks per reservation is available for persons who caring for someone age 60 or older.  Available from the Area Agency on Aging 1-B Out-of-home Respite (OHR) Program, (800) 852-7795.

A database to find and compare Medicare-certified nursing homes based on a
location, compare the quality of care, and their staffing:
https://www.medicare.gov/care-compare/?redir=&providerType=NursingHome 

Information on nursing homes, including formal complaints, is available from Alzheimer’s Association, (800) 273-3900.

Information and lists of nursing facilities and private and licensed assisted living facilities in SE Michigan are available from the Area Agency on Aging 1-B, (800) 852-7795.

Investigation of complaints of abuse and/or neglect of elderly persons is available from the Department of Human Services - Adult Protective Services Division:  

Hospice services are available from: 

• CHECKLIST TO EVALUATE IF MOM AND DAD CAN STILL LIVE AT HOME

As people age, they can develop difficulties performing everyday activities. This checklist can help families determine what resources might be appropriate now and help prepare for the future. For further help, consult a physician, geriatric-care manager, county social service department or other professionals. For each task below, check the one description that best fits the situation of the person you are concerned about. Add the numbers to get a score, then find the recommendation for that score on the next page.

Scoring the Evaluation - What kind of help is needed?

SCORE 21-30            

People with this score function independently.  There may be no need for services now, but start exploring options.  Make sure that legal and financial plans are in place. Consider which level of care family members would be able or willing to give, as needs change.

Tips:

• Talk as a family with your older relative about medical, financial and legal arrangements and personal preferences.  Encourage them to fill out a health-care directive (living will) and to write a will, or to review existing documents.
• Help older adults do as much as possible for themselves, and recognize your own limitations. That can help them remain more vigorous and alert and help you avoid caregiver burnout.
• Find out about community resources. Keep a file of articles and advertisements for services. Tour senior housing and assisted-living apartments in the area.
• Complete a home-safety evaluation to minimize the risk of falls and to improve safety.
• Review this assessment regularly to track changes.

SCORE 31-50            

People with this score may be unable to complete some important daily activities without help. Consider several options:

• Community-based services include a broad spectrum of help.  Evaluate whether some of them are practical and affordable. Some seniors qualify for economic assistance through a county social service office. For safety, it may be more difficult for people with memory loss to continue to live at home.
• As needs increase, cost of services may exceed similar services in residential care homes or assisted-living apartments.
• Adult day care provides structured activities and meals. Some offer health services and transportation. Most can be attended full or part-time.
• Companion programs provide in-home visitors who can help with shopping, meals, housekeeping and companionship. They do not provide medical care and usually do not give personal care such as bathing or dressing. Twenty-four-hour care can run upwards of $175 a day.
• Home health care provides medical care in the home. Services may be provided by a nurse, occupational, speech or physical therapist, or home aide.
• Assisted-living apartments provide some supervision, 24-hour security and on-site staff. Residents can buy care as needed.  Many units have kitchenettes, but residents may choose to eat in a common dining room.
• Residential care/memory-loss homes are similar to assisted living, and are designed for people with Alzheimer’s or other memory-impairing illnesses.

SCORE 51-66            

People with this score are unable to care for themselves and have health problems. Some may need rehabilitation and may be able to return home.

• Nursing homes provide complete personal and medical care for people who are unable to manage independently. That can include short-term rehabilitative services as well as long-term care for  very frail people.
• Residential care/memory-loss homes are designed for people with Alzheimer’s or other memory-loss conditions. They can work well for people who need supervision but do not need intensive medical care.
• 24-hour home health services are available to very frail people who prefer to remain at home and receive 24-hour care from a home health agency. This will cost much more than nursing-home care.  Hospice services include medical and social programs for terminally ill people and their families.

N.B., Other options is to have the senior live at home but use Adult Day Care for daytime caregiving needs, the PACE program or the MI Choice program. (See the Senior Citizens Chapter)