display screens for memory impared pricelist

The PMIS is a quick and reliable screen for dementia that can be used in older adults with little or no education. It discriminated cognitively normal older adults from those with dementia regardless of age, sex, education, severity of dementia, or presence of depression. All participants completed the PMIS, which took approximately 4 minutes including the interference task. High interrater reliability was demonstrated between administration of PMIS by the clinician and the nurse. The high alternate-forms reliability supports use of different PMIS sets for repeated testing. Professionals and nonprofessionals successfully administered the PMIS in urban and rural clinic settings. The PMIS was administered on a computer screen and using cards. These findings support the feasibility of using the PMIS in various settings and by personnel with different levels of expertise.

Pictures are remembered better than words. The visual component of the PMIS involves deeper or additional layers of cognitive processing; enhancing learning and recall. Poor visual memory predicts dementia,

Table 2 shows sensitivity and specificity based on the sample and PPV and NPV at hypothetical dementia base rates that can guide choice of cut-scores. A sensitive PMIS cut-score can be used to monitor cognitive function in older adults and guide timing of follow-up visits, whereas a specific cut-score with high PPV can be used to avoid false-positive cases when recruiting candidates for clinical trials involving potentially toxic medications.

The initial step in evaluating older adults presenting with cognitive complaints is to detect or exclude dementia regardless of subtype. Because the PMIS is a cognitive screening test, individuals who fail it should be referred for definitive diagnostic assessment. Alternatively, individuals scoring in the normal range could be asked to return for a repeat screen at a longer interval.

This tablet doesn’t require Wi-Fi; it can send and receive data through a 4G LTE connection. In fact, its large 1920×1200 full HD display is perfect for seniors who prefer a larger screen and text. It comes complete with colorful icons and large text to make it easier for seniors experiencing memory or vision loss. If you’re an older adult with dementia, you can use the simplified video chat feature to stay connected with loved ones. With loud speakers and dual speakers, you can easily browse the internet, listen to music, or play popular games like sudoku or other brain games to improve memory.

The GrandPad is user-friendly and great for users who have minimal experience using tablets or cell phones. When I turned on the device, I was able to watch the welcome video, which reviewed all of the important features of the tablet, ranging from photos to contacts. I liked that this tablet lets you create a private circle where a family administrator can be in charge of managing the GrandPad and creating a close circle of family contacts. With the GrandPad, there’s no dialing or typing required; all you have to do is simply touch the screen and click on large fonts and buttons to navigate and connect with loved ones. For instance, when I wanted to make a call, all I had to do was click on the photo of a loved one, and it automatically placed a call.

The RAZ Memory Cell Phone is the only cell phone specifically designed for seniors with dementia or Alzheimer’s, although it is also a good choice for some seniors who just want a very simple experience.  The cell phone is based on 3 design principles: (1) it is incredibly easy to use for the senior, (2) the phone can be managed from afar through a feature called Remote Manage, and (3) every additional capability offered by the phone is optional.

The RAZ Memory Cell Phone has one primary screen.  The screen accommodates up to 6 contacts with an option for up to 30, with contact pictures and names underneath.  The pictures help individuals with dementia who cannot always remember the names of their contacts or who may have difficulty reading.  There is also a button to call 911; the user does not have to enter the digits.  To make calls, the senior taps and holds the picture of the person they want to call.  That’s it!  There is no menu system, no apps, no ability to access settings …etc.

With simplicity in mind, the phone’s volume button is disabled and is always set to maximum, the screen does not lock or go to “sleep” (the display is always on), and even the power button can be disabled.   Here is a demonstration video of the RAZ Memory Cell Phone.

Normally a cell phone’s features are managed in device settings or in individual applications.  In the case of the RAZ Memory Cell Phone, to maximize simplicity and to accommodate the fact that many caregivers do not live with their loved ones, the cell phone is managed through a feature called Remote Manage.  Remote Manage allows caregivers to manage all aspects of the RAZ Memory Cell Phone from afar, using a mobile application or an online portal.

Receive text message alert when battery is low –The care partner will receive a text message when the battery of the RAZ Memory Cell Phone decreases to a specified level.

Reminders –Remind your senior about events or things they should do. A sticky note will appear on the RAZ Memory Cell Phone, and there is an option for an audio message, as well.

RAZ Emergency Service – The RAZ Memory Cell Phone includes a dedicated 9-1-1 button. The senior simply presses the button to contact emergency services.  If the senior has the habit of repetitively calling 9-1-1, which is not uncommon for individuals with more advanced dementia or Alzheimer’s, the care partner can subscribe to the RAZ Emergency Service for $79.99 per year.  Calls are routed to a private dispatch service and the dispatch agents know that the caller suffers from memory loss.  Also, care partners are notified of emergency calls by text message and can “cancel” the emergency.

The RAZ Memory Cell Phone is a smartphone with a 6.5-inch display, which provides a lot of real estate for contacts and their pictures.  The large display also helps people with vision loss.  It has a modern “tear-drop” design with minimal bezels.  Nobody can tell from the design that the phone is for seniors with dementia or Alzheimer’s, which means that users will not feel self-conscious that they have a “special” phone.

The display itself is very bright.  It dims a little when it has not been used for 2 minutes in order to save battery power.  Even in this dimmed state, it can be seen easily by seniors.  As soon as the user touches the dimmed display, it brightens.

The price of the RAZ Memory Cell Phone is $349.00 and works on all major wireless providers, including Verizon, AT&T, T-Mobile, Consumer Cellular, Mint Mobile, Affinity Cellular, and other compatible networks.  The phone is unlocked.  In other words, the user can select his or her wireless provider and plan.  Currently, the phone comes with a free SIM card and three (3) free months of service from either MINT Mobile or Affinity Cellular.

The KidsConnect KC2 Phone is designed for children.  The company website describes the phone as a parent’s “All In One Security Solution”.  Nevertheless, the phone is sometimes purchased for individuals with dementia or Alzheimer’s as a result of its simplicity.

The senior can call up to three (3) contacts with the physical speed dial buttons.  There are no pictures displayed on the cell phone, so the user must remember which contact is associated with each number.  To place a call, the senior must press and hold the speed dial button for three (3) seconds.  An additional twelve (12) people can be contacted with the touch screen.  To make calls with the touch screen, the senior must tap “Phone” and then tap the number that they wish to call.  Again, there are no pictures.  Depending on the user’s level of dementia or Alzheimer’s, navigating this menu system may or may not be possible.  Watch a video to see the basic operation of KidsConnect.

The phone cannot dial 911, but it does have an SOS button that will call and send text messages to up to three numbers.  The text message will say that an SOS has been triggered.  The inability to call 911 may be a deal-breaker for some.

The phone offers GPS tracking and geo-fencing, which may be very useful features for finding a wandering senior with dementia.  The phone also offers text messaging, a stopwatch, and access to settings through the touchscreen menu system.  These additional features add some complexity to the device and may be confusing to individuals with dementia or Alzheimer’s.

Unlike with the RAZ Memory Cell Phone, the volume button is not locked down, so the user can inadvertently lower the volume without realizing it.  Further, like many cell phones, the KidsConnect locks after a certain period of time.  Some users may have difficulty unlocking their cell phone.

The price of the KidsConnect phone on the KidsConnect website is $199.95.  Wireless plans are purchased through the KidsConnect website and cost $45/month for unlimited service with T-Mobile coverage and $60/month for unlimited service with AT&T coverage.

Unlike the RAZ Memory Cell Phone or the KidsConnect KC2, incoming calls cannot be limited to contacts.  Thus, if you are concerned about the senior being taken advantage of by predatory telemarketers, the Jitterbug Flip2 is probably not a good option.

The Jitterbug Flip2 is really all about the health services.  It advertises itself as a “personal safety device.”  The Basic health and safety package is priced at $19.99 per month (on top of the cost of your cell phone service), and most notably includes a private emergency dispatch service, as well as a service that sends medication reminders.  There is also a Preferred package for $24.99 and an Ultimate package for $34.99.  The Preferred package includes access to a board-certified doctor or nurse without an appointment.  The Ultimate package includes a personal operator that can help the user with tasks, such as looking up addresses or phone numbers.  These services are accessed by pressing the 5Star Button.

The Jitterbug Flip2 supports other features, including text messaging, a camera, call history, a flashlight, magnifier, clock, calculator, and FM Radio.  It also has Amazon Alexa, which allows the senior to ask it for information, such as the weather.  It does not support video calls.

By default, the RAZ Memory Phone displays up to six pictures of contacts. If memory loss is more severe, the phone can display only one or two pictures.

When the phone rings, two big buttons will appear. A green one that says “Answer” and a red one that says, “Hang up”. If the caller is a contact, a large picture and name of the caller will be displayed.

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Screening for dementia, much like screening for other diseases or chronic conditions, is a good way to detect the changes that can be signs of the onset of disease or other change in cognition. Memory screening and early detection provide:The ability to make lifestyle and other beneficial changes earlier in the disease process when they have the greatest potential for positive effect.

Time to connect with community-based information and supportive services prior to a potential crisis situation related to the needs of the person with dementia or the caregiver.

To enable people with dementia and their caregivers to benefit from memory screening and early detection, a community-based memory screening program was developed by the Wisconsin Department of Health Services and the Wisconsin Alzheimer’s Institute using the Animal Naming Screen, the Mini-cog, and the AD8.

The Animal Naming and Mini-cog tools were selected after a pilot study in Portage County in 2009. The Wisconsin Alzheimer’s Institute, the Aging and Disability Resource Center (ADRC) of Portage County, and DHS demonstrated the acceptability and effectiveness of using the Animal Naming and Mini-cog screens in a community setting. The Animal Naming screen is attached as Appendix C (PDF) and the Mini-cog as Appendix D (PDF)

Results from the pilot demonstrated ADRC customers’ high level of acceptance of screening. The offer of a memory screen was accepted by 243 out of 254 people, a 96% acceptance rate. This result contradicts the idea that people do not want to be screened for dementia. The tools were also effective in detecting cognitive issues. Of the 243 people who were screened, 150 (63%) had results that indicated they should follow up with their physician. This result may seem surprisingly high, but screens were only offered to individuals who expressed a concern about their memory, so those with cognitive issues self-selected into the study. Of those 150 people, 120 or 80% agreed to have the results sent to their physician.

The Animal Naming and Mini-cog screens were selected not only for their acceptability and effectiveness, but also because they are brief, easy to administer and score, and are sensitive to early cognitive changes. Some screens must be administered by physicians or psychologists and can take more than an hour. The minimum level of training required and the short length of time necessary to administer the screens was a critical component in their acceptance for use by ADRC staff.

The screens were also selected because they have documented utility as dementia screens and tap key skills likely to be affected in mild to moderate dementia. The Animal Naming screen involves retrieval from semantic memory and executive function, two areas of cognition that reliably decline in people with Alzheimer’s disease. In a study of memory clinic clients with a high base rate of dementia, the Animal Naming screen was shown to have 85% sensitivity and 88% specificity for differentiating Alzheimer’s disease and other dementia from normal cognition. The Mini-cog screen tests memory as well as visuoconstruction and executive function, with studies showing sensitivity for dementia of 76% to 99% and specificity of 83% to 93% in analyses that excluded patients with mild cognitive impairment.

Memory screens are voluntary, so there will be individuals who decline to participate. On these occasions, if family caregivers are uncertain whether their concerns about the person they are caring for are valid, the AD8 screen can help determine whether a visit to the doctor is recommended. The AD8 (PDF) tool is available in both English and Spanish. This screen is intended to help the caregiver think through the changes they see in a family member, and may help them to realize it is time to take action. The screen can be provided to the family caregiver to complete on their own, or the questions can be asked by the screener in a private setting. The AD8 has sensitivity for dementia of greater than 84% and a specificity of greater than 80%.

In 2020, the Montreal Cognitive Assessment (MoCA) tool was added to the approved tools for use by dementia care specialists (DCS). This tool is not for use by ADRC staff other than the DCS. The intention behind the addition of the MoCA screen is to give DCS an additional tool for situations that are more complex. While the Mini-cog and the Animal Naming screens are more sensitive to earlier changes than other screens, they are limited to a few areas of cognition. The MoCA covers a wider variety of cognitive tasks and provides additional insight into possible cognitive impairment when the Animal Naming and Mini-cog results do not reflect the changes in cognition and behavior reported by the individual or their family.

New dementia care specialists should become very familiar with the Animal Naming and Mini-cog tools prior to adding the MoCA to their toolkit. There are some similarities and some differences between the activities of the Animal Naming and Mini-cog and those in MoCA. Learning all the screens at the same time can be confusing, so it is advised for new staff to focus on the Animal Naming and Mini-cog screens, as well as the AD8, prior to becoming certified to provide the MoCA screen. Training and certification for the MoCA, and the approved form, are available from the official MoCA website. There is a cost to the training and certification for the MoCA. The MoCA is not required to be provided as a part of this program but is available as a supplemental tool.

The primary intent of this memory screening protocol is to enable and enhance conversations about memory concerns. The screens are not diagnostic tools and do not make any determinations about mental status. The screens are similar to a blood pressure check, in that a high blood pressure reading does not mean an individual has cardiovascular disease, but is a signal to talk to a physician about the results. The screens can be a reason to bring up the topic of memory issues because they can be offered in the moment. A referral to the physician can be more meaningful if an objective tool verifies that an individual’s concerns with memory and cognition should be further assessed.

It is appropriate to offer a memory screen when one is requested, or when working with a customer who displays signs of possible memory loss or confusion. ADRC specialists are able to offer the screening program during a visit for another purpose, if time allows. It is preferable to address the concerns around memory at the time, rather than putting off the discussion for another appointment. Memory screening is always voluntary.

Staff members may feel uncomfortable offering a memory screen if they are not used to asking and answering questions about memory and dementia. It is important that staff who are offering the screens understand why screening is important and helpful to the customer. Practicing offering the screen to coworkers and family members can be a good way to become more comfortable. Staff must be trained to follow the guidance in this manual before performing memory screens with the public.

If other people are present for the screening, let them know they will need to remain quiet and not help the person answer the questions. Ensure the participant cannot easily view and copy a clock in the room.

Begin with Animal Naming. It is critical to read the instructions for each task on both screens exactly as they are written. Do not explain how the screen is scored prior to performing the screen, and only afterwards if the individual asks you to do so. To adhere to the fidelity of the tools, they must be performed exactly the same way every time to ensure the results are valid. Read the instructions to the participant: “Please name as many animals as you can think of as quickly as possible.” Be prepared for the person to start listing animals immediately or, if they do not, prompt them with “Go.”

Once the person begins to name animals, start the timer and record all the animals named within 60 seconds in the spaces provided on the worksheet. If the person is speaking quickly, write as much of the word as needed to remember what was said and fill in the remaining letters afterward. If the person falls silent, follow the prompting instructions. Once the Animal Naming screen is done, administer the Mini-cog, even if the score of the Animal Naming screen was very high. The two screens should always be used together.

The Memory Screening in the Community program is intended for the Animal Naming tools and the Mini-cog tool to be used in combination. In this non-clinical program, the standard Mini-cog tool available online has been adapted to work in concert with the Animal Naming Tools. Refer to Appendix D to access the form to record results.

Begin the Mini-cog by telling the participant, “I am going to say three words I want you to remember,” and repeat the three words listed on the worksheet. Be sure to read the instructions exactly as they are written. It is important to the fidelity of the screen to use the same three words every time the screen is performed. Give the participant three chances to repeat the words back. If the participant does not repeat the words, or does not repeat them correctly, the screener can repeat the words up to three times until the words are repeated correctly. If they are not correct after the third time, move on to the clock draw.

Provide a blank, standard, letter-size sheet of paper for the participant to draw on and a writing utensil. This can be the back of the Animal Naming worksheet or another blank sheet. Allow the participant time to adjust to the new task, pick up the writing utensil, and adjust the paper. Once the participant is settled, read the instructions for the clock draw exactly as they are written, pausing when indicated to allow the participant to complete the task. Move on from this task if the clock is not complete within three minutes.

There will be individuals that frequently request to be screened. If they express the desire for an alternate set of words used for the three-word recall portion, refer to the words listed in the Health Equity section for Hmong translation. The need for an alternative set of words was first identified in the need for the translation of the words into Hmong. they do not easily translate into that language, so an alternative set of words was identified for that purpose. That substitution can also be applied for individuals who request frequent screening.

The AD8 can be administered to the person with possible memory loss, but often individuals with dementia lose insight into their condition and are not reliable self-reporters. The questions on the screen can either be read aloud or a caregiver can fill out the form on their own. In situations where the person with possible memory loss is together with the caregiver, allowing the caregiver to fill out the questionnaire silently may be less upsetting for the person with possible memory loss than if the questions are asked aloud. The caregiver may also provide different answers if the person with possible memory loss is listening to the answers.

The MoCA tool, including training, certification, and the downloadable version of the paper tool can be found on the MoCA website. The MoCA is also available to be used digitally. Instructions for how the MoCA tool is scored are a part of the training and certification process.

The Memory Screening in the Community program was adapted in 2020 during the COVID-19 pandemic for use when screening was required to be completed virtually. The ability to provide screening virtually for dementia risk has been identified as an ongoing need. Please consult Section IV: Accessibility and Health Equity Considerations for a description of the adaptation for virtual access.

The use of the Animal Naming and Mini-cog tools in the Memory Screening in the Community Program is different than as a part of Wisconsin’s Long-Term Care Functional Screen (LTCFS). The purposes for the use of these tools in the Memory Screening in the Community Program are to enable a conversation and assist in determining whether speaking to a physician is advisable. The LTCFS uses the tools to represent “memory loss” if the individual being screened states that they have memory loss but do not have an accompanying diagnosis of dementia. The LTCFS is used to determine functional eligibility for long-term care programming and uses the results of the screens independently. The scoring key for the Memory Screening in the Community Program to determine if a referral is recommended is attached in Appendix E.

The Animal Naming tool is a categorical fluency test. The person is asked to recall specific labels for items in a specified category, such as animals. The tool is scored by tallying the number of correct responses. If the person names fewer than 14 correct animals, that is considered “not passing.”

The Mini-cog has two areas that are scored. Three points are awarded for recalling the three words correctly, and a score of either zero or two is awarded for the clock draw. For the three- word recall, one point is given for each word remembered. The words do not have to be in the same order in which they were presented.

The clock draw test requires some interpretation by the screener. The rules for scoring the clock draw are attached inAppendix G. There are examples of clocks drawn by participants in the pilot study that can be used to practice interpreting results in Appendix H. It is important not to overthink the interpretation of the clock; the clock is only one piece of the screening program. If a clock drawing looks correct but there are some questionable features, use your best professional judgment to make a decision and then move on.

The screens are conversation tools and do not provide a diagnosis; they are used to determine the need for an appropriate referral to a physician. If the scores from the screens do not indicate the need to make a referral to a physician, but the conversation about the individual’s memory concerns suggests that a referral would be helpful, a referral should still be offered.

The AD8 is scored by tallying the number of items noted as “Yes, a change.” If the score is two or more, a referral to the physician is appropriate. The instructions for determining the score of the AD8 can be found after the screening questions on the AD8 tool.

Training for the scoring of the MoCA tool can be found on the MoCA website. The MoCA is available to be used digitally, which can assist in scoring the results.

The screener can also offer to send in screening results for individuals whose scores do not fall into the range where a referral is recommended for the purposes of providing a baseline screen for their medical records. A baseline score is useful in detecting change over time. If an individual has several years of baseline scores in his or her record, detecting a change in cognitive abilities is easier to track and therefore easier to detect and respond accordingly.

If the person who was screened chooses to have the screening results shared with a physician, the screener must first obtain a signed ‘release of confidential information’ form giving permission to the screener to share the information. An example of this type of form is located in Appendix I, although most agencies will have their own form that must be used for this purpose.

Sending the screening results to the physician is also an opportunity to make the physician aware of the agency and its services as well as the community screening program. Cover letters should include information about the person who was screened, a short explanation of the screening process, information about the agency and a statement encouraging the physician to refer patients who receive a diagnosis back to the agency for ongoing support. A sample letter to the physician is attached in Appendix J.

The Wisconsin Alzheimer’s Institute (WAI) and the dementia care specialist from Eau Claire County developed additional resources for use after the tools have been completed. For individuals whose screening results show they should talk to their doctor, Dr. Cindy Carlsson at the WAI developed a one-page document to accompany screening results sent to the physician by the screener. The document includes best practices around evaluation for possible dementia and when to refer a patient to the WAI Memory Diagnostic Clinics network. This resource can be found inAppendix K. Appendix L is the Memory Screening Results and Recommendations form available to provide the person after screening and is optional. Having the results and recommendations written in one place can be helpful to the person. Additional information and resources can be provided at the time or sent in a follow-up correspondence.

Once the tools are completed and a physician referral is recommended, the screener should ask permission to follow up after two to six months, even if the individual does not want the results sent to the physician. Agreeing to a follow-up call indicates openness to additional support in the future. If the person who was screened does indeed have dementia, they will need information and support in the future, and following up after a screen can allow that to happen in a planful way and not in crisis.

The Memory Screening in the Community Program can be provided in a variety of settings. Typically, screens are available whenever a customer requests a screen, or when a trained ADRC specialist or dementia care specialist identifies a customer that would benefit from the program. They are also usually performed in person. This can be during a home visit or office visit scheduled for another purpose. However, there are many possible locations for memory screening to be performed in the community. Partnering with municipal and other local governmental agencies to offer screens is one option. For example, public libraries are welcoming places free from the stigma associated with dementia and are often willing to host screening events in a private study room or other private space. Community or large employer health fairs also offer opportunities to screen, and to normalize screening for cognitive decline along with other health conditions.

County-based programs, healthy aging programs, public health departments, and other community-based partner agencies may also have staff trained and supported by the dementia care specialist at the ADRC to provide the Memory Screening in the Community Program. The same requirements for fidelity, oversight, and yearly refresher training apply to all screeners trained by the DCS.

The Memory Screening in the Community Program was adapted during the COVID-19 pandemic to be available virtually. When the program cannot be provided in person, there is a substitute protocol for use of the program virtually. Please consult Section IV: Accessibility and Health Equity Considerations for a description of the adaptation for virtual access.

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Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

The cost of assisted living in New Jersey for seniors needing memory care services averages $8,119 per month, which is $2,494 higher than the national average rate of $5,625. New Jersey"s neighboring state of Delaware reports slightly lower prices for memory care at $7,494, while in New York ($5,725) and Pennsylvania ($5,125), costs are lower by more than $2,000 per month.

The costs for memory care in New Jersey can vary widely depending on the location sought for assisted living. For instance, the capital city of Trenton has one of the state"s highest rates at $10,181 monthly, with memory care in Ocean City averaging $818 less at $9,363. Costs in Atlantic City are less than the state average at $7,259, while rates in Vineland are on par with the state"s median costs at $8,000 per month.

The New Jersey Comprehensive Medicaid Waiver encompasses the state"s Medicaid Managed Long Term Services and Supports (MLTSS) program. This program provides eligible seniors with medical care and support services via a managed health care organization (HMO or MCO) under the auspices of NJ FamilyCare. Assisted living and memory care services may be covered under this managed care program for seniors who meet eligibility requirements and have personal care needs consistent with several daily living tasks.Who Is Eligible:Individuals who are U.S. citizens and residents of New Jersey must be 65 years old and up to be considered for the MLTSS program. Applicants must meet clinical guidelines for needing a nursing home level of care. Financial eligibility requirements include limits on gross income and countable assets.

How To Apply: Seniors already covered under the state"s Medicaid program, NJ FamilyCare, must contact their managed care organization"s member services department to set up an assessment for long-term care services and/or placement. If not already covered under NJ FamilyCare, individuals must first apply for Medicaid by contacting a representative of the Aging and Disability Resource Connection within their county to receive help with the application process or by applying online or in person to a local county Department of Social Services office.

The financial eligibility requirements for seniors applying to receive long-term care services in New Jersey are limited to certain maximum monthly income amounts and countable liquid assets. The current 2022 income limit cap for a single applicant is $2,523 per month. There is a resource limit restriction of $2,000 or less.

However, if income is more than the eligibility limit, applicants can open a Qualified Income Trust (QIT) with the amount in excess of the limit amount to qualify for services.

All income and assets must be disclosed for a "look-back" period that includes transactions performed over the past five years to determine financial eligibility. Some assets may be exempt for applicants, such as a primary home (with an equity limit of $858,000), one vehicle, an irrevocable funeral trust and certain life insurance policies.

resourcecontactdescription877-222-3737Seniors can get assistance with the Medicaid application process through their county"s Area Agency on Aging Disability and Resource Connection (ADRC) office. "Options Counseling" is a component of MLTSS that helps counselors identify seniors" needs for certain services on an individualized basis.

800-701-0710A component of the New Jersey Department of Human Services, NJHelps has health benefit coordinators available to assist seniors who are applying for NJFamilyCare and MLTSS programs.

833-677-1010Staffed by certified local agents, Get Covered NJ is the state"s official health insurance marketplace where seniors can find out if they qualify for NJ FamilyCare and MLTSS and other types of financial help.

800-356-1561Run by the Department of Human Services and state social services caseworkers, this phone service helps seniors determine eligibility for Medicaid services in New Jersey.

Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.

That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:Long-term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It"s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.

Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This option can be a good way to fund memory care in the short term, but the loans will need to be paid back after the home"s sale. The most commonly used type of reverse mortgage for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.

Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.

In New Jersey, assisted living facilities (ALFs) that provide residential memory care are regulated and licensed through the Department of Health (DOH), Division of Health Facilities Evaluation and Licensing. ALFs are licensed for a minimum of four residents, but New Jersey regulations do not specify maximum occupancy limits. There are two types of residential ALFs in the state:Assisted living residences (ALRs), which are purpose-built

Facilities that offer Alzheimer"s and dementia care are required to have admission and discharge guidelines in place and ensure that staff attend a mandatory dementia training program. Additionally, facilities must have a written plan for activities, safety policies and specific procedures relating to memory care residents that can be provided to staff, residents, family members or the public upon request.

To ensure compliance with state regulations and continued quality of care, the Division of Health Facilities Evaluation and Licensing performs unannounced inspections of all licensed facilities every two years, as well as investigative inspections in response to complaints.

ALR and CPCH facilities in New Jersey should operate according to assisted living values that encourage and promote independence, dignity and privacy for residents in a homelike environment. These facilities provide housing along with a coordinated range of 24-hour supportive services to meet the needs of residents. The personal and health-related services offered may be provided by the facility"s staff or arranged through outside providers and may include:Assistance with personal care

According to New Jersey regulations, assisted living settings are appropriate for those who can respond to their environment, demonstrate independent activity, interact with others and express volition. State regulations allow ALR and CPCH facilities to accept individuals with a wide range of disabilities and frailties. They also stipulate that 20% of a facility"s residents must require a nursing home level of care. The table below provides a general guide on individuals who may and may not be admitted to an ALR or CPCH:

ALR and CPCH facilities in New Jersey are required to obtain a healthcare provider"s assessment for each resident in the 30 days prior to their admission. This is necessary to verify that the level of care the facility provides is appropriate for the individual"s needs. Details on the person"s nursing requirements, preferences and usual routines should also be obtained from their current caregivers, if applicable.

When a resident is admitted, an initial assessment by an RN is required to determine what services the individual needs, and a general service plan must be developed within 14 days after admission. If the person requires healthcare services based on the initial assessment, an RN must complete an additional assessment. Those diagnosed with Alzheimer"s or other forms of dementia must be assessed to determine their cognitive and functional abilities.

Based on these assessments, the facility is required to develop a personalized care plan for the individual during their first 14 days of residency. The service and care plans for each resident must be reviewed quarterly and revised as needed to reflect changes in their physical and/or cognitive condition.

Alternatively, facilities may designate trained, supervised staff, including certified home health aides and nurse aides to administer medication. These staff members must complete a medication aide course, pass an exam to become certified and be supervised by an RN. It is also required that facilities use a unit-dose drug distribution system for the delegated administration of medications.

There is no minimum staff-to-resident ratio required in ALRs and CPCHs, but state regulations include specific staffing guidelines for these facilities:In facilities licensed for more than 60 residents, the administrator or a designated alternate must be on-site and available on a full-time basis.

ALRs and CPCHs are also required to provide personal care staff with orientation training before they begin working with residents. This training should cover assisted living concepts, care of residents with physical impairments, pain management and infection prevention and control, as well as abuse and neglect, resident rights and emergency procedures.

Ongoing training is also required for all direct-care staff members:Facility administrators need to complete 30 hours of DOH-approved continuing education every three years.

Additionally, facilities that offer memory care services must provide training in dementia and Alzheimer"s care for all staff members directly involved in the care of memory-impaired residents.

New Jersey Medicaid covers the cost of services provided in ALR and CPCH facilities for eligible enrollees through the Managed Long Term Services and Supports program. However, those who qualify for the program are responsible for paying the room and board portion of the monthly fees charged by their facility.

New Jersey families and seniors living with memory-related impairments may be able to access several free or low-cost resources through government-run or nonprofit organizations. Services such as nutritional assistance, transportation and advocacy are a few of the resources available.

888-280-6055New Jersey seniors and their families impacted by Alzheimer"s disease and other memory impairment issues can access the professionally staffed helpline, programs and services provided by this nonprofit organization. Experts in the dementia field deliver educational seminars and run support groups and wellness programs, in addition to providing connections to community support.

800-272-3900With services geared toward seniors living in Southern New Jersey, this Alzheimer"s Association chapter provides local services and education as well as a hotline for residents.

New Jersey Long-Term Care Ombudsman877-582-6995This free advocacy service offers conflict resolution and education concerning residents" rights for seniors living in nursing, assisted living and memory care facilities.

Department of Military and Veterans Affairs609-530-4600Veterans and their spouses can apply for Aid and Attendance and other benefits through various service offices throughout the state to help cover memory care costs in assisted living facilities in New Jersey. This is a needs-based payment in addition to a VA pension to pay some of the costs associated with long-term care, and it"s typically awarded to individuals with Alzheimer"s disease or other forms of dementia.

Note:The following information was compiled and most recently updated on 2/10/2022. Since COVID-19 is a rapidly evolving crisis, be sure to contact your Memory Care Facility or local Area Agency on Aging for the most up-to-date information.

When patients complain of problems with memory, psychiatrists should in general initiate testing immediately so that if AD is indicated, a cholinesterase inhibitor may be initiated right away to slow the disease progression.

There are several tests psychiatrists can perform in their offices that do not take an exorbitant amount of time and still have clinically significant sensitivity and specificity. Based on the results of these tests, psychiatrists can then decide when and whether to refer these patients on for further, more formal testing. The following tests are brief and among the most effective.

The “WORLD” test. The first test is to ask a patient to spell the word “world” forward and backward and then list the letters in “world” in alphabetical order. This test is scored as wholly correct or incorrect and has been found to have a sensitivity of 85 percent and a specificity of 88 percent for AD.

Patients naming as many words as they can in one minute that start with the letter F may also be revealing, but to a lesser extent. Combining the two “naming” tests may help differentiate, however, the kind of dementia a patient has. For example, if a patient is less able to generate letter F words than to generate names within a specified group, he or she may be more likely to have vascular dementia.

The Mini-Cog test. A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia. If the patient can recall one or two words, the level of accuracy of his or her clock drawing then becomes definitive. If the patient is unable to recall any of the words, it is inferred that he or she has dementia, and more formal testing should be initiated.

An important additional point here is that if a patient does not recall the words, psychiatrists can prompt him or her by revealing the general categories of the words to the patient, such as “a flower,” or by going further and giving the patient several specific choices, including the right one. If the patient can recall the right word, he or she retains some capacity for recall.

The Montreal Cognitive Assessment test. Finally, the Montreal Cognitive Assessment test (MoCA), a more recently developed test, takes 10 minutes to administer and, like the MMSE, involves 30 measures. It is available at www.mocatest.org at no cost. It involves several additional tests. The tests, along with instructions for administering and scoring, are available in 11 languages, including Spanish, Chinese, and Arabic. The MoCa has been shown to detect mild AD with 100-percent sensitivity and 87-percent specificity.

Part-Exchanging your car means selling it to a third party and contributing the sum that they pay for your car towards the purchase of your new car. Part-Exchanges in connection with purchases of Lotus vehicles on this Website are handled by a third party called BCA Outsource Solutions Limited (“BCA”). If you wish to Part Exchange your car you will need to obtain an online valuation to obtain an indicative value at which BCA may be willing to buy your car from you. This valuation tool (Tool) is owned and powered by BCA. By using this Tool you accept and agree that any valuation generated by the Tool (an “Online Valuation”) is based on the information you tell BCA about your car (the “Car”) and on the following general assumptions BCA makes about your Car (the “Assumptions”):

You have the option at the Online Valuation presentation page to amend any of the Assumptions and provide BCA with some further detail about your Car. An Online Valuation is not an offer by BCA to purchase the Car. It is simply a tool to enable you to estimate the value of your Car. Subject to BCA’s inspection of the Car (as explained further below) and any material change in the market value of your car, the Online Valuation is guaranteed for 30 days from the date and time at which you receive your Online Valuation. If you wish to proceed with a Part Exchange, the sale of your vehicle to BCA will be subject to agreeing terms and conditions with them. A copy of BCA’s terms and conditions can be found here. Please make sure that you are happy with them before proceeding. Your sale of the Car to BCA at the price indicated on this site will be subject to you providing further information and a physical inspection immediately prior to its sale to confirm its condition and any other relevant factors.

No one test can confirm that someone has mild cognitive impairment (MCI). A diagnosis is made based on the information you provide and results of tests that can help clarify the diagnosis.

Problems with memory or another mental function. People with MCI may have problems with memory, planning, following instructions or making decisions. A provider may confirm these issues with a family member or a close friend.

Mental status testing shows mild level of impairment for age and education level. Health care providers often use a brief test such as the Short Test of Mental Status, the Montreal Cognitive Assessment (MoCA) or the Mini-Mental State Examination (MMSE). More detailed testing may help determine the degree memory is impaired. The tests also may reveal the types of memory most affected and whether other mental skills also are impaired.

As part of a physical exam, a health care provider may perform some basic tests that can reveal how well the brain and nervous system are working. These tests can help detect signs of Parkinson"s disease, strokes, tumors or other medical conditions that can impair memory and physical function.

Longer forms of tests can provide details about how someone"s mental function compares with others of a similar age and education. These tests also may help identify patterns of change that offer clues about the cause of symptoms.

The Alzheimer"s medicine called cholinesterase inhibitors is sometimes given to people with MCI whose main symptom is memory loss. However, cholinesterase inhibitors aren"t recommended for routine treatment of MCI. They haven"t been found to affect progression to dementia, and they can cause side effects.

In 2021, the Food and Drug Administration (FDA) approved aducanumab (Aduhelm) for the treatment of some cases of Alzheimer"s disease. The medicine was studied in people living with early Alzheimer"s disease, including people with MCI due to Alzheimer"s disease.

Another Alzheimer"s medicine, lecanemab, has shown promise for people with mild Alzheimer"s disease and mild cognitive impairment due to Alzheimer"s disease. It could become available in 2023. Not all people with MCI are expected to be eligible for the treatment, since only some have MCI due to Alzheimer"s disease.

Lecanemab is under review by the FDA. Another study is looking at how effective the medicine may be for people at risk of Alzheimer"s disease, including people who have a first-degree relative, such as a parent or sibling, with the disease.

Other common conditions besides MCI can make you feel forgetful or less mentally sharp than usual. Treating these conditions can help improve your memory and overall mental function. Conditions that can affect memory include:

High blood pressure. People with MCI tend to be more likely to have problems with the blood vessels inside their brains. High blood pressure can worsen these problems and may cause memory loss. Your health care provider will monitor your blood pressure and recommend steps to lower it if it"s too high.

Depression. When you"re depressed, you often feel forgetful and mentally "foggy." Depression is common in people with MCI. Treating depression may help improve memory, while making it easier to cope with the changes in your life.

Sleep apnea. In this condition, your breathing stops and starts several times while you"re asleep, interfering to get a good night"s rest. Sleep apnea can make you feel very tired during the day, forgetful and not able to focus. Treatment can improve these symptoms and make you more alert during the day.

Omega-3 fatty acids also are good for the heart. Most research on omega-3s that shows a possible benefit for brain health looks at how much fish people eat.

Some supplements — including vitamin E, ginkgo and others — have been suggested to help prevent or delay mild cognitive impairment. However, more research is needed in this area. Talk to your health care provider before taking supplements as they can interact with your current medicines.

Because appointments can be brief and there"s often a lot to talk about, it"s good to be well prepared. Here are some ideas to help you get ready for your appointment and know what to expect from your provider.

What you can doBe aware of any pre-appointment restrictions. When you make your appointment, ask if you need to fast for bloodwork or if you need to do anything else to prepare for diagnostic tests.

Write down all of your symptoms. Your health care provider will want to know details about what"s causing your concern about your memory or mental function. Make notes about some of the most important examples of forgetfulness or other lapses you want to mention. Try to remember when you first started to suspect that something might be wrong. If you think your difficulties are getting worse, be ready to explain why.

Take along a family member or friend, if possible. Corroboration from a relative or trusted friend can play a key role in confirming that your memory loss is apparent to others. Having someone along also can help you remember all the information provided during your appointment.

Make a list of your other medical conditions. Your provider will want to know if you"re currently being treated for diabetes, heart disease, past strokes or any other conditions.

Because time with your health care provider is limited, writing down a list of questions will help you make the most of your appointment. List your questions from most pressing to least important in case time runs out. For cognitive changes, some questions to ask your provider include:

Your provider also is likely to have questions for you. Being ready to respond may free up time to focus on any points you want to talk about in-depth. Your provider may ask:

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