Dementia Care in Delaware: A Caregiver's Guide (2026)

If you are caring for a parent or spouse with dementia in Delaware, two phone calls open almost every door. One is a free 24/7 helpline; the other is the Delaware Aging and Disability Resource Center (ADRC), part of the state's aging division, DSAAPD. This guide gives you both numbers and the programs behind them.

Dementia care in Delaware is its own kind of hard: the long arc, the behavioral changes, the safety worries, the grief that starts before any loss. The Alzheimer's Association estimates that about 22,000 Delawareans aged 65 and older were living with Alzheimer's in 2020, and that 37,000 family caregivers support people living with dementia in the state.1 Below is the Delaware-specific help available in 2026, from Medicaid in-home care to the programs that can pay you for the care you already give.

You do not have to navigate this alone, and you do not have to fund all of it from your savings.

Where to Start With Dementia Care in Delaware

When a diagnosis lands, or when caregiving starts to outpace what you can manage alone, these three contacts open most doors in Delaware. Make the calls first; everything else can wait until you have caught your breath.

Delaware Dementia Caregiving, by the Numbers

The Alzheimer's Association's 2026 Facts and Figures report estimates that 22,300 Delaware adults aged 65 and older, 11.3 percent of that age group, were living with clinical Alzheimer's dementia in 2020; that year, not 2026, is the one the estimate covers. For 2025, the same report counts 37,000 Delaware caregivers of people with Alzheimer's or other dementias, giving 67 million hours of unpaid care.1

If the work feels overwhelming, that is not a personal failing. It is the reality of a condition that demands more, for longer, than almost any other.

Who Pays for Dementia Care in Delaware

Delaware dementia families draw on four separate payers, each with its own rules: Delaware Medicaid, the VA (for veterans), Medicare, and out-of-pocket. The art is stacking them.

Delaware Medicaid (Diamond State Health Plan Plus)

For Delawareans who qualify, Diamond State Health Plan Plus (DSHP-Plus) is the state's managed-care Medicaid program for long-term care. Besides nursing facility care, it covers home and community-based services meant to prevent or delay nursing home admission, which the state says might include adult day care, home meal delivery, personal care assistance, personal emergency response systems, and respite care. The state's fuller benefit list also names cognitive services, assisted living care, case management, and consumer-directed attendant care. The Division of Medicaid and Medical Assistance (DMMA) developed the program in partnership with the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD).3

DMMA's DSHP-Plus page does not publish the eligibility criteria, so do not assume a single test decides it: ask DMMA what the qualifying criteria are for a relative with Alzheimer's or a related dementia.3 The Delaware ADRC at 1-800-223-9074 can also help you understand available services and explore care options.2

Getting Paid to Care for a Loved One With Dementia

Some Delaware dementia caregivers can be paid for the care they provide, through Delaware Medicaid or, for veterans' families, VA programs. On the DSHP-Plus benefit list, ask about consumer-directed attendant care by name: it is the route through which an attendant the member chooses is paid.3 The pathways, who can be hired, and the pay are covered in the Delaware paid family caregiver guide.

VA Benefits (for Veterans)

If the person you care for is a veteran, two VA pathways can help pay for dementia care: a caregiver program for veterans enrolled in VA health care, and an add-on to VA pension.

The Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays a monthly stipend (which VA called a nontaxable benefit when it proposed the current rules in 2020) to the veteran's approved Primary Family Caregiver, who can be a spouse, adult child, or other family member. VA's first screen has four conditions, and all of them must be true for the veteran: a VA disability rating (individual or combined) of 70% or higher, discharge from the military or a date of medical discharge, a need for at least six months of continuous, in-person personal care, and enrollment in VA health care. Meeting those four doesn't settle it. The veteran and caregiver apply together, and the regulation adds further conditions VA checks during that process, including that the same personal care is not already being regularly provided by another person or program. Approval alone doesn't start the money either: the caregiver must enroll in direct deposit through VA's customer engagement portal to receive the stipend. The stipend is not a flat national figure: it is calculated from the federal pay scale (OPM GS-4, step 1) for the area where the veteran lives, so the dollar amount varies by locality. PCAFC also provides caregiver training, counseling, and at least 30 days of respite care a year.5

Separately, VA Aid and Attendance can add money to a VA pension, which is for wartime veterans who meet age or disability requirements and income and net-worth limits; someone who gets that pension may be eligible if they meet at least one of VA's tests, such as needing another person to help with daily activities like bathing, feeding, and dressing. For 2026 (effective Dec 1, 2025 through Nov 30, 2026), the Maximum Annual Pension Rate with Aid and Attendance is $29,093/year for a veteran with no dependents, $34,488/year for a veteran with one dependent, and $18,697/year for a surviving spouse with no dependents; that rate is a ceiling, not a payment: VA bases what you get on the difference between your income for VA purposes and that rate, and net worth is capped (2026 limit $163,699).6 For caregiving questions, the VA Caregiver Support Line at 1-855-260-3274 (Monday through Friday, 8 a.m. to 8 p.m. ET) can connect you to your local VA Caregiver Support Program team.7

Medicare

When a patient shows signs of cognitive impairment at a routine or yearly Wellness visit, Medicare Part B covers a separate visit to assess cognitive function and write a care plan (billed as CPT 99483); after the Part B deductible, the patient pays 20% of the approved amount. Medicare also covers certain home health services for a person who is homebound and needs part-time or intermittent skilled care, and hospice when a hospice doctor and the person's regular doctor certify a life expectancy of 6 months or less and the person chooses comfort care. Medicare does not pay for long-term custodial care (ongoing non-medical help with bathing, dressing, and using the bathroom) when that is the only care a person needs. The GUIDE Model, where a participating provider operates near you, adds dementia care navigation, a 24/7 support line, caregiver training, and respite for traditional-Medicare beneficiaries. For the performance year that began July 1, 2026, CMS pays up to $2,625 per eligible patient for respite, and CMS pays the participating provider, not the family. GUIDE respite is limited to patients with moderate or severe dementia whose primary caregiver is a relative or an unpaid nonrelative, and patients who live in assisted living or another residential care community cannot get it.8 Ask your neurologist or the Alzheimer's Association helpline whether a GUIDE provider is available.

Respite for Dementia Caregivers

Respite is what makes the long haul survivable. In Delaware, respite comes through three main channels. DSHP-Plus lists respite care among its covered services for members.3 Through the Lifespan Respite Program, eligible caregivers can apply for respite vouchers to help cover the cost; you may qualify if you care for an older adult, a child or adult with disabilities, or, as a caregiver aged 55 or older, a relative's child. The federal National Family Caregiver Support Program also funds respite care, and its eligible caregivers include family members caring for someone of any age with Alzheimer's disease and related disorders.2 The Eldercare Locator at 1-800-677-1116 can connect you to your local Area Agency on Aging.4 For the full picture, see Respite Care in Delaware.

A few days a week at an adult day program gives you reliable hours back. Some adult day centers follow a specialized model built around one diagnosis, most often dementia, so ask any program you are considering whether it is one.9

Managing Safety, Behavior, and Legal Planning

Dementia raises issues other caregiving does not, and most of them are easier to handle before a crisis forces the question.

• Wandering. Keep a recent photograph or video of your loved one to help police if they become lost, let neighbors and the local police know that they tend to wander, and consider a door alarm or a GPS tracking system.10 The Alzheimer's Association 24/7 Helpline (1-800-272-3900) offers free care consultations for individualized, solution-focused support.2
• Driving. Deciding when to stop driving is one of the hardest conversations. The Alzheimer's Association suggests asking the physician to advise your loved one not to drive and to write a letter or prescription stating that the person must not drive, which you can then use to remind them what has been decided.11
• Legal documents, signed early. A power of attorney has to be put in place while your loved one can still take part in the decision, and it is one of the less-restrictive alternatives that can avoid the need for a court guardianship.12 The two core health-care advance directives are a living will and a durable power of attorney for health care, which names a health care proxy to make medical decisions when your loved one cannot.13 See Advance Directives: A Caregiver's Guide for the documents and how to get them.

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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.