Where care happens: home or a facility
Path 2: Comfort first. The other path: Keep looking for causes.
- Call ALTCS before you decide anything: 888-621-6880. (Arizona's Medicaid for long-term care.)
- Medicare does not pay for long-term care. (Only short skilled stays, home health and hospice.)
- Hospice comes wherever they live. (Room and board stays with whoever paid it.)
- Memory care? Ask, "If she becomes bedbound, can she stay?" (Get it in writing.)
The settings side by side
| Setting | Phoenix monthly cost | Who pays | How to get in |
|---|---|---|---|
| Home aides Family covers nights and two-person lifts | $38 an hour; about $27,700 round the clock | You, ALTCS, the VA, long-term care insurance | An agency, ALTCS or the VA |
| Hospice at home Daily care: family or aides | Hospice $0, up to $5 a prescription | Medicare; ALTCS too | Step by step |
| Adult day program Weekday daytime care and meals | About $2,058 (Arizona median, 5 days a week) | You, ALTCS, the VA, GUIDE respite money | Call; ask about scholarships. Arizona programs. |
| Memory care Bedbound residents may have to move | Assisted living $6,000, plus any memory care charge | You, VA; ALTCS: care, not room and board | Tour, check AZ Care Check, ask about ALTCS |
| Nursing home Nurses around the clock, bedbound care | Shared room $9,003; private $12,167 | You, then ALTCS; the VA for some veterans | Care Compare, AZ Care Check, ALTCS approval |
Worth knowing: long-term care insurance can pay toward memory care and nursing homes. ALTCS can pay family caregivers at home.
| Stay | Who pays | How to get in |
|---|---|---|
| Inpatient hospice home When home cannot ease symptoms; respite up to 5 days | Medicare, when hospice says it is needed; otherwise room and board is yours | The hospice team arranges it. Phoenix inpatient homes. |
| Senior psychiatric unit A locked hospital stay when behavior puts anyone at risk | Medicare Part A: $1,736 deductible, then $0 for 60 days; ALTCS too | Usually through the ER; ask the questions below |
Before a psychiatric stay, ask: "Will the home take them back? What medicines will you start?" (These units change medicines under watch; they do not cure dementia. Most stays last 3 to 14 days.)
Danger right now? Call 911. (Then: when they hit, grab or threaten you.)
Arizona memory care: what to check
- The license says "directed care." (Arizona's level for people who cannot recognize danger, call for help or make basic care decisions.)
- Bedbound, or a deep bedsore? They may have to move. (Arizona's rule, unless their doctor examines them and signs that the home can still meet their needs.)
- License history and inspections: AZ Care Check. (State licensing: 602-542-1025.)
ALTCS: Arizona's Medicaid for long-term care
For people who need nursing-home-level care, "at little or no cost."
| Item | 2026 figure |
|---|---|
| Income, one person | Up to $2,982 a month |
| Savings, one person | Up to $2,000 |
| Savings a spouse at home keeps | Half the couple's countable savings: at least $32,532, at most $162,660 |
| Income allowance, spouse at home | $2,705 up to $4,066.50 a month |
- Income over the limit? An income-only trust may still qualify them. (They may owe a share of cost; estate recovery applies after age 55.)
- The care test is an interview, the PAS. (An older adult needs 60 points; a dementia diagnosis counts 20, and wandering, aggression and disorientation count too.)
- Bring: the written diagnosis, every doctor's name, power of attorney or guardianship papers, a list of the unsafe things they do, and someone who can describe the hard days.
- Give nothing away without advice. (Arizona looks back 5 years; gifts bring a penalty period. Gifts up to $1,500 a month do not count.)
- Apply at Health-e-Arizona Plus, or call 888-621-6880. (About 45 days. Name a trusted person who can answer the phone in business hours.)
At home, ALTCS pays for attendant and personal care, homemaking, meals, home health, adult day health, hospice, and up to 600 hours of respite a year.
Medicare's short nursing-home stays
Medicare pays only after 3 days in a row as a hospital inpatient, and only while the care is skilled.
| Days | You pay |
|---|---|
| Days 1 to 20 | $0 after the $1,736 deductible |
| Days 21 to 100 | $217 a day |
| Day 101 on | All of it |
- In the hospital, ask: "Is she an inpatient, or under observation?" (Observation and ER time do not count. The admission day counts; the discharge day does not.)
- Enter within about 30 days. (Some Medicare Advantage plans waive the 3-day rule.)
Sedating drugs in facilities
- Look up the home's own rate on Care Compare. (Typical US homes: 8% to 20%. Assisted living and memory care have no federal rate: ask them in writing.)
- You must be told before a sedating drug is started or raised, and you can say no. (Federal nursing-home rules ban drugs used for staff convenience.)
- Worried? Call the long-term care ombudsman, free. (ltcombudsman.org, or 1-800-677-1116.)
What leads to a move, in studies
- Their needs. (Severe memory loss, needing help with basic daily care, behavior changes, depression. Incontinence did not reliably predict a move.)
- Your strain. (Caregivers under more stress, or feeling trapped, moved their person more often.)
- Nights. (70% of caregivers named night problems in the decision, mostly their own lost sleep.)
- Your health. (Strained spouse caregivers had a 63% higher death rate than people not caregiving.)
What keeps people home: support for you. (In a trial, spouses given counseling and ongoing support kept their partner home about 18 months longer.)
How to decide
- This week, call ALTCS: 888-621-6880. (Ask, "Would she qualify, and what would you pay at home and in memory care?")
- Call a GUIDE program too: Banner 623-832-6500, option 6, or Hospice of the Valley 602-636-6363. (Ask, "Are we eligible, and is there respite money?")
- A veteran? Ask the VA social worker about home help, respite and Aid and Attendance.
- Write down what a day and a night take, and how your health is holding.
- Look at places early. (Good places have waitlists. Ask: "If our money runs out, can she stay?" What to look for.)
- If you may need ALTCS, apply before the money is gone.
If it's just you: Phoenix's Area Agency on Aging answers day and night, 602-264-4357. Ask about benefits help, free legal help at 60 and over, and the ombudsman.
Our biases, out loud: we lean on government rules, one national cost survey and older mainstream US studies. The AI assistant that helped research this leans toward establishment sources and hedged wording.
Checked 14 October 2026. Rules and prices change; confirm with ALTCS and each place. Sources.