Living with dementia? Here's how much it might potentially cost

When we think about the challenges of living or caring for someone with dementia, the first things we think about are the social and psychological challenges.

People with dementia require more attention because the condition can lead to memory loss, personality changes, and difficulties with balance and coordination.

These can pose a strain on the time and energy of caregivers. At the same time, these challenges lead to financial costs when they require specialised facilities to make life more comfortable.

We will talk about the costs you need to consider when living with dementia or someone who does.

Care considerations for someone with dementia

If you or someone else you know has dementia, there are a variety of care options that you can choose from. These options range from external care facilities to home care services.

We will provide a brief description of what each care consideration includes followed by a price range estimate.

All the costs stated below are estimated costs and may vary based on the service providers you choose.

Hospice daycare 

Hospice care provides full-time compassionate care for residents with advanced physical and mental health conditions. Hospice care would be best for people with advanced dementia where they might require round-the-clock supervision.

Hospice staff can also help people with dementia who have other medical conditions that need specialised care, like changing feeding tubes or catheters.

Cost of in-patient hospice care services: $250-$350 per day

Some hospice centres also provide home hospice care, where hospice staff care for patients in the patient's own home if they cannot afford the cost of a hospice stay.

Home hospice care is available through some voluntary welfare organisations like Assisi Hospice and Metta Welfare Association.

These organisations would require you to submit a means test form and to confirm that there is a caregiver staying in the patient's home as the medical team would not be living on-site.

Respite care

Respite care is catered to provide caregivers with a break by taking over care for a short period of time.

Respite care would be good if you are a caregiver who cares at home for your family member with dementia most of the time and needs breaks to attend to other matters.

Night care is also available which would be helpful for people with dementia who display sundowning behaviours, where they become disoriented and restless from dusk to dawn.

Cost of respite care services: $100-$150 per day

Cost of night care services: $50-$230 per hour

Senior daycare centres

Senior daycare centres provide care and activities for seniors during their opening hours.

Activities that your senior can take part in at daycare centres include chair hockey, art and crafts, and playing musical instruments like the ukulele.

Some centres offer specialised care for people with dementia which includes occupational and music therapy to help people with dementia maintain their mental faculties.

The staff at senior daycare centres are also able to help seniors with activities of daily living that they cannot do on their own, such as feeding, moving around, or transferring from a bed to a chair.

Most senior daycare centres are open on weekdays and closed on weekends and public holidays. You can find out more about these and other elder care services here.

Cost of senior daycare: $900-$1700 per week before subsidies (assuming daily attendance)

Domestic worker

Hiring a domestic worker to take care of yourself or someone else with dementia is a possible option for constant home care.

Domestic workers can also be useful for larger families as they can perform other tasks, like cooking and caring for children, relieving some burden on yourself or a caregiver.

However, you would need to keep in mind that many domestic workers are not professionally trained to take care of older people with specialised medical needs.

Cost of hiring a domestic worker: $600-$850 per month excluding living costs, extra pay if they decide to work on off-days, skills training costs etc.

Meal delivery

You can opt into specialised meal delivery services for older people so that you can avoid having to cook for yourself.

There are also low-cost meal delivery services run by non-profit organisations like Bethesda Care Services and Meals on Wheels by the Agency for Integrated Care (AIC).

These services might require a referral from a hospital or polyclinic.

Cost of Meals on Wheels delivery service: $4.80-$6.96 per meal before subsidies

Laundry service

Laundry services can include sending clothes to the laundromat or dry cleaner.

Laundry services for seniors are also available from senior home care services that provide professional help in managing the household chores for older people living on their own.

Such laundry services include washing, ironing, folding, and arranging clothes. This can be done either with the facilities in one's home or at the company's laundry.

Cost of laundry and dry-cleaning service: $2-$7.50 per kg

Housekeeping

Housekeeping services would include sweeping, vacuuming, air-con servicing and sometimes also specialised disinfecting services. Some housekeeping service providers even provide manicures and pedicures!

With professional housekeeping services, you can choose to let them come over once a week or once a fortnight. Fees can be calculated by the hour or per session, and many companies have additional weekend surcharges.

Cost of housekeeping services: $20-$106 per hour

Medical escort service 

For older people living alone who have difficulties with moving around, medical escort services are available to take seniors to and from medical appointments.

Medical escorts can be non-emergency ambulance vehicles that can transport seniors who are wheelchair users or have difficulties moving around on their own.

Medical escort services are especially important for seniors living alone without caregivers to prevent them from missing hospital trips or important medical appointments.

Cost of medical escort services: $62-$90 per round trip

ALSO READ: Caregiver guide: How to start keeping a dementia journal for your loved one

Other cost considerations that come with dementia care 

Home upgrades and facilities

Living with dementia would involve upgrading your house to improve its accessibility for people with a lower physical and mental capacity.

These upgrades would include installing anti-slip floors, grab bars in areas like the bathroom to prevent falls, caregiver pagers that someone with dementia can press whenever they require assistance, or elevator chairs to help one go up and down the stairs.

Cost of installing pagers: $26-$40 (not including delivery and shipping costs)

Cost of installing grab bars: $94-$269 per bar

Cost of installing elevator chair: $3,000 to $10,000 (depending on the shape of your staircase)

Diagnosis cost considerations 

While you might assume that your senior has dementia and treat them accordingly, it is still important to get a diagnosis recognised by a practicing doctor. An official diagnosis can be obtained through referral to the geriatric department of any hospital.

The costs of diagnosis would include visits to a specialist as well as the costs of running diagnostic tests. These tests can include brain scans, a psychiatric evaluation, laboratory tests of blood or spinal fluid, and a neurological evaluation.

Nevertheless, early diagnosis has been shown to be able to cut the costs of dementia care by nearly 30 per cent as it can reduce spending on unnecessary tests and treatments.

Cost of brain scan: $375

Cost of psychiatric evaluation: $124-$188 per hour

Cost of neurological evaluation: $180-$200 per session

Cost of laboratory tests: $400 for positron emission tomography (PET)

Treatment cost considerations 

Dementia treatment includes physical and psychiatric treatments that help people with dementia maintain their physical and mental faculties.

Such treatment methods include occupational therapy, rehabilitation, and medications.

Reminiscence and life story work, which encourages people with dementia to remember and recount their life histories to help improve their memory, is also another form of non-medical treatment available.

The later that dementia is diagnosed, the more you might have to spend on treatment.

Cost of rehabilitation sessions: $140-$180 per session at a private clinic

Cost of medication: $200 per month

Cost of occupational therapy sessions: $180 per session

Subsidies for dementia care 

As we have seen above, the costs of dementia care can add up to a lot.

Thankfully, there are subsidies and grants available to lessen the burden of dementia care and treatment.

Levy concessions from the Ministry of Manpower (MOM) are available to subsidise the cost of hiring foreign domestic workers to provide care to family members who need it.

Employers are eligible for the concession if they live with a child who is less than 16 years of age, a senior aged 67 and above or a person with special needs. The levy is capped at two domestic helpers per household, one for each person who requires care.

If you require a domestic helper to take care of a family member who requires assistance with three or more activities of daily living (ADLs), you can apply for AIC's Home Caregiving Grant of up to $200. More information can be found on the MOM website.

The Caregivers Training Grant is available to caregivers of people with dementia to attend courses that can let them learn relevant caregiving skills.

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The grant is disbursed by AIC and is available for caregivers of individuals who are Singapore citizens or Permanent Residents (PRs).

The grant provides $200 for caregivers to enrol in any course of their choice that has been approved by AIC.

These courses include those on dementia awareness and would be very helpful for a caregiver of someone with dementia. Foreign domestic workers are also eligible to attend. 

Under the Pioneer Generation Scheme, older Singaporeans can also enjoy subsidies for healthcare costs. Seniors can use their Community Health Assistance Scheme (CHAS) cards to receive special subsidies at eligible clinics.

The degree of subsidies you can receive varies with the colour of your card. Subsidies for treatment of a chronic condition like dementia can range from $28 to $90 per visit for Pioneer Generation card holders.

All Merdeka Generation and Pioneer Generation card holders can receive CHAS benefits regardless of income or the annual value of your home. More information on the subsidies can be found on the CHAS website.

This article was first published in Homage.