Lifelines
Local Help Costs Depend on a Few Known Factors: What Decides the Price of Dementia Support in St. Louis
Many local programs are free, some are priced on a sliding scale, and others charge a set fee, and the difference usually comes down to a few factors you can ask about before you sign up.
When a support program says it is free, it often means free to you on the day you walk in, which is a different thing from free to run. The cost you feel depends on a short list of factors, and most of them are written down somewhere if you know to ask. Before you call anyone, decide what you are willing to pay for and what you hope someone else covers.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Who the program is built for
Many local programs set eligibility by who the service is for: the person living with memory changes, the family caregiver, or both. Some require that the person live in a particular area or county. Some take a referral from a doctor or a social worker. Each of those rules can change whether you pay at all. Ask what the eligibility rules are, and ask whether a referral is needed before you call, not after.
Sliding scales and set fees
A sliding scale ties the fee to household income or to what the family can afford, and the program usually asks for a short financial form. A set fee is the same for every household. A grant-funded program may be free to you while still reporting visits or hours to its funder. Ask which kind of pricing applies, whether the scale is reviewed on a schedule, and what paperwork you need to bring. Do not treat the first answer as the final one.
What the price covers
A program fee can cover the group session, the staff time, the materials, or a ride. Two programs with similar names can differ on exactly what is included. Make a list of the pieces you need, such as a ride from home, a meal, someone to sit with her for an hour, or a phone line you can call after hours. Then check each piece against the program's written description. The items left off the list are the ones you will end up paying for out of pocket.
Benefits and other payers
Some costs are shared with a benefit you already have, such as a veterans program, a county service, or an employer plan. Whether that applies depends on the specific program and the specific benefit, so ask the program directly which payers it bills and which it does not. The benefit office or a case worker can tell you what is on file for your household. Keep the answers in writing, with the name of the person who gave them.
Compare with the same questions
When you have two or three options, ask each one the same five things: who is eligible, what kind of fee applies, what is included, what is not included, and who else pays. Write the answers side by side on one page. A program that answers clearly and in writing is giving you what you need to decide. One that answers vaguely is telling you something too.
The Lifelines page lists the St. Louis area programs this site covers, which makes it a good starting point for those calls. How this site checks its facts is explained on the How We Write page.