Caring for a parent with dementia in Michigan: what Home Help can and can't cover

The short answerMichigan Home Help pays for help with a list of daily tasks, ranked by how much human help the person needs. Only tasks ranked 3 or higher are paid. Companionship and supervision on their own are not on the State's list of tasks. A State Adult Services Worker decides what is approved for your parent, and we cannot say what that would be.

If your parent has memory loss, you may be doing a lot already: reminding, checking in, making sure the stove is off, being there. It is natural to ask whether Home Help can pay for any of it. The honest answer is that it depends on the tasks, and the State decides.

What Home Help pays for

Home Help pays for help with seven personal care tasks (bathing, dressing, eating, grooming, mobility, toileting and transferring) and five household tasks (housework, laundry, taking medication, meal preparation and cleanup, and shopping for food and medication). These come from the State's Adult Services Manual, ASM 120. Our guide to what Home Help pays for goes through each one.

How the State ranks each task

For each task, the Adult Services Worker ranks how much human help the person needs, from 1 to 5:

• 1: independent.
• 2: verbal assistance, such as reminding, guiding or encouraging.
• 3: some human assistance, such as direct physical help.
• 4: much human assistance.
• 5: dependent.

Only tasks ranked 3 or higher are paid. That matters if your parent can still do a task but needs to be reminded. If a task needs only reminding, it is ranked 2, and a caregiver who reminds and encourages but does not do the task is not paid for that task.

What Home Help does not pay for

Our reading of the State's task list is that companionship and supervision on their own are not listed tasks, so they are not paid as such. Time beyond the approved monthly total is not paid either. If most of what you do is keep your parent company or keep watch, ask the county office how that is treated before you plan around any payment.

What may count

If your parent needs a person to help with bathing, dressing, eating, taking medication or the other listed tasks, that help is what the assessment looks at. Describe the real picture, task by task, including what happens on a hard day. Do not overstate it, and do not downplay it. Our guide to preparing for the Home Help assessment shows how.

The other program to ask about

Home Help is not the only Michigan Medicaid program for care at home. The MI Choice Waiver is a separate program with its own list of services, and you start with the MI Choice waiver agency in your community. Many families ask both offices. See MI Choice Waiver or Home Help for how they differ and what we could not confirm.

A note on safety

If anyone is in danger, call 911. To report suspected abuse, neglect or exploitation of an adult, call Adult Protective Services at 1-855-444-3911.

What we cannot tell you

We cannot say whether your parent qualifies, which tasks would be approved, how many hours the State would set, or whether a family member can be paid. Only the State decides. Your county MDHHS office can tell you how to ask for an assessment.

Common questions

Does Michigan Home Help cover dementia care?

Home Help does not pay for a diagnosis. It pays for help with listed tasks: seven personal care tasks and five household tasks, as ranked by a State Adult Services Worker. The State decides which tasks and how much time are approved for any person.

Will Home Help pay someone to keep an eye on my parent or keep them company?

Our reading of the State's task list is that companionship and supervision on their own are not listed tasks, so they are not paid as such. Ask your county MDHHS office how your parent's needs would be assessed.

Is reminding my parent to do something paid?

Not on its own. On the State's 1 to 5 scale, a task where the person needs reminding, guiding or encouraging is ranked 2, and only tasks ranked 3 or higher are paid. Hands-on help, such as direct physical assistance, ranks 3 or higher.

Is there another Michigan program I should ask about?

Yes. The MI Choice Waiver is a separate Medicaid program with its own list of services. MDHHS says to start by contacting the MI Choice waiver agency in your community. Many families ask about both programs.

Who decides what is approved for my parent?

An Adult Services Worker at the State decides, after an assessment. We cannot say whether your parent qualifies or how many hours would be approved.

This is general information, not legal, medical or benefits advice. Whether someone qualifies depends on the State's decision for that person. Rules change, so confirm with MDHHS. Already Caring is a private company and is not part of MDHHS or the State of Michigan.