Does Structured Family Caregiving Cover Dementia Care in Georgia?

Yes, Structured Family Caregiving (SFC) can cover care for a person with dementia in Georgia. SFC is part of Georgia's Elderly and Disabled Waiver Program (EDWP). The state's EDWP fact sheet says plainly that Alzheimer's and dementia count as physical conditions for eligibility.

A diagnosis alone is not enough, though. Your loved one still needs Georgia Medicaid and a nursing-home level of care. The paid caregiver must be a relative who lives in the home. This guide explains how dementia fits each rule, who can be the caregiver, and what support you get.

SFC and dementia at a glance

• Does dementia count? Yes. Georgia treats Alzheimer's and other dementias as physical conditions for EDWP.
• What decides eligibility? A home assessment of daily needs, plus Medicaid and level of care.
• Who can be paid? A relative by blood or marriage who lives with your loved one.
• Who cannot be paid? A spouse, a legal guardian, or a parent of a minor child.
• What support comes with it? A health coach, a registered nurse for questions, daily notes, and yearly training.
• Where to start in Atlanta: Empowerline, the Atlanta Area Agency on Aging, at 404-463-3333.

Who qualifies for SFC when a parent has dementia?

Your parent must meet the same rules as anyone else in EDWP. Dementia does not lower the bar or raise it. The DCH EDWP fact sheet lists the core rules.

• A qualifying condition. A functional impairment caused by physical limitations. Alzheimer's and dementia count.
• Nursing-home level of care. A doctor must approve the need for an intermediate level of nursing home care.
• Medicaid. Your parent must be eligible for Medicaid, or likely to be eligible after a financial screening.
• A care plan. A physician must approve the care plan.
• A choice to stay home. Your parent prefers care at home to a nursing home.
• A high daily need for help. SFC is for members assessed as needing a large amount of hands-on personal support each day.

Georgia's 2022 waiver renewal goes further. It says a person may qualify because of cognitive impairment, typically linked to Alzheimer's or another dementia. It also sets aside some program capacity for people with these diagnoses. You can read the rules in Georgia's EDWP waiver renewal application.

For more on the level-of-care rule, see what nursing home level of care means in Georgia.

How does Georgia measure dementia needs in the assessment?

Georgia uses an assessment tool called the Minimum Data Set Home Care (MDS-HC). The waiver says the first assessment covers physical, cognitive, social, emotional and environmental status. Memory and thinking problems are part of the picture, not an afterthought.

That matters for dementia. Many people with early or middle-stage dementia can still walk, eat and dress. Their need is often for reminders, cueing and someone watching over them. Georgia's own definition of personal support includes "watchful supervision and oversight" while the usual caretaker is away.

Bring a list of medicines and the names of your parent's doctors. If a neurologist or memory clinic has seen your parent, bring those notes too. The assessor can only count the needs they hear about.

Who can be the paid caregiver for someone with dementia?

The caregiver rules are the same for every SFC member. They often trip up dementia families, because many have set up a guardianship. Georgia's waiver says the caregiver and member must be related by blood or by marriage.

Empowerline, the Atlanta Area Agency on Aging, adds that the caregiver must be at least 18 and pass a criminal background check. It lists conservators among those who are not eligible. See its EDWP and SFC information page.

For every caregiver rule in one place, read the full SFC requirements checklist. If you are married to the person with dementia, see can a spouse be paid as a caregiver in Georgia.

What support does an SFC caregiver get for dementia care?

SFC is more than a payment. It is a support service for the family caregiver. Georgia's waiver describes SFC as support, education and oversight for members whose family caregiver lives in the home.

• Health coach

  A coach who works with you on your loved one's needs and goals

• Registered nurse

  At least one Georgia-licensed RN available for health questions as needed

• Daily notes

  Short electronic notes on changes or concerns, reviewed by the agency each day

• Monthly contact

  A home visit or phone contact at least once a month

• Yearly training

  Caregiver training each year that reflects your loved one's assessed needs

• Shared updates

  The agency shares note information with the case manager and doctors

The daily notes are useful for dementia. Changes in sleep, mood, appetite or confusion can be early signs that something else is wrong. A note today can prompt a call to the doctor this week.

When might SFC not be the right fit for dementia?

SFC works best when one relative can live with the person and provide steady care at home. Some situations call for a different EDWP service.

• No relative lives in the home. SFC requires a live-in family caregiver. Personal support from an agency aide may fit instead. See our guide to Personal Support Services in Georgia.
• Home is no longer safe. EDWP includes Alternative Living Services. Georgia's waiver notes these settings serve some people with dementia who cannot live with family.
• Care needs become medically complex. The waiver says personal care for medically unstable or complex members cannot replace care by a nurse or other licensed professional.
• The caregiver needs daytime breaks. Adult day health and respite are separate EDWP services. Ask the care coordinator which ones can be combined with SFC.

Georgia's waiver says separate payment is not made for personal support, home-delivered meals or Alternative Living Services while SFC is in place. The care plan has to fit together.

How can you keep a parent with dementia safe at home?

Safety is part of daily dementia care. MedlinePlus, from the National Institutes of Health, gives home safety guidance for families. A few of its main points:

• Use door alarms and an ID bracelet with contact details if your parent may wander.
• Lock up all medicines, cleaning products and sharp objects.
• Remove stove knobs when the stove is not in use.
• Clear tripping hazards and lower the hot water temperature.
• Do not leave a person with advanced dementia alone at home.

Read the full MedlinePlus guide to dementia safety at home. Talk to your loved one's doctor or nurse about their specific risks.

How do you start SFC for a parent with dementia in Atlanta?

1. 1

   Check the basics

   Confirm your parent has Medicaid, or may qualify, and that you live together.

2. 2

   Call the Area Agency on Aging

   In metro Atlanta, call Empowerline at 404-463-3333, or the statewide line at 866-552-4464.

3. 3

   Complete the screening

   Staff ask about needs and urgency. Your parent may go on a waitlist.

4. 4

   Prepare for the home assessment

   List the hardest days, current medicines and doctors' names.

5. 5

   Choose an SFC agency

   Once SFC is on the care plan, an approved agency enrolls the caregiver and starts support.

The Georgia.gov EDWP application page notes that EDWP often has a waitlist. Calling early puts your parent in line sooner. For a full walk-through of how SFC works, read what Structured Family Care is and how Georgia's SFC program works.

How A1-GA Healthcare Agency helps

A1-GA Healthcare Agency is a Georgia DCH-approved Medicaid home care provider in Norcross. We have provided in-home care since 2008 and staffed caregivers since 2004. We offer Structured Family Caregiving in Atlanta for families caring for a loved one at home, including a loved one with dementia.

We can explain the rules, help you prepare for the assessment, and support you as a caregiver once SFC begins. If SFC is not the right fit, we will tell you.

• Phone: 678-446-1832
• Hours: Monday to Friday, 8am to 6pm
• Email: [email protected]
• Check eligibility: Start the free eligibility form