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

About 459,300 Texans age 65 and older were living with clinical Alzheimer's dementia in 2020, and roughly 1.3 million Texans care unpaid for someone with Alzheimer's or another dementia. If you are one of them, Texas has more support than you may realize.1

Dementia caregiving is its own kind of hard: the long arc, the behavioral changes, the safety worries, the grief that starts before any loss. This guide maps the Texas-specific help available in 2026, from the free 24/7 helpline to Medicaid respite to the programs that can pay you for the care you already provide.

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

Texas Dementia Caregiving, by the Numbers

The scale of dementia caregiving in Texas is enormous and growing. About 459,300 Texans age 65 and older were living with clinical Alzheimer's dementia in 2020, roughly 11.9 percent of that age group; the Texas Department of State Health Services states the same estimate as approximately 460,000 in the 2024-2028 Texas State Plan for Alzheimer's Disease. Counting Alzheimer's and other dementias together, an estimated 1,287,000 family and other unpaid caregivers in Texas provided about 1.91 billion hours of unpaid care in 2025, valued at roughly $35.6 billion. Alzheimer's deaths in Texas rose about 227.8 percent between 2000 and 2021, and nationally Alzheimer's disease is the sixth-leading cause of death.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.

Where to Start

When a diagnosis lands, or when caregiving starts to outpace what you can manage alone, a few free contacts open most doors in Texas. None charges a fee or requires an eligibility test to call.4

Texas's Dementia Care Support Infrastructure

The Alzheimer's Association and Alzheimer's Texas

The Alzheimer's Association operates six chapters serving Texas: Houston and Southeast Texas, Dallas and Northeast Texas, North Central Texas, San Antonio and South Texas, Capital of Texas (Austin), and West Texas, which covers Amarillo, El Paso, Lubbock, the Permian Basin, and San Angelo. Each runs support groups, education programs, and care consultations. Separately, Alzheimer's Texas, an independent organization serving Central Texas, provides information, referrals, and support programs.2

Texas DSHS Alzheimer's Disease Program

The Texas Department of State Health Services (DSHS) runs an Alzheimer's Disease program with caregiver education, resource guides, and links to local services. It is a useful starting point for understanding the landscape of state and community resources.2

Area Agencies on Aging, ADRCs, and Take Time Texas

Texas's 28 Area Agencies on Aging, administered under Texas Health and Human Services (HHSC), are the front door for most non-Medicaid caregiver support: individual counseling, support groups, training, and respite, funded in part through the federal National Family Caregiver Support Program. The state's Take Time Texas portal helps you find local respite providers. ADRCs round this out by connecting families to the full menu of Medicare, Medicaid, and community services.3

DPRIT: Texas's Dementia Research Investment

In November 2025, Texas voters approved Proposition 14, a constitutional amendment establishing the Dementia Prevention and Research Institute of Texas (DPRIT) and authorizing $3 billion to fund dementia, Alzheimer's, and related-disease research. The Alzheimer's Association has described it as the largest state-funded dementia research initiative in the nation.2

The money is not moving yet, though, and that is worth knowing before you count on it. The governor said he would not certify the November 2025 election until a voter lawsuit over it was resolved. A Travis County judge ruled for the state on February 4, 2026, but the fund still could not go into effect while the suit remained live. So DPRIT is approved rather than operating. When it does start, it will fund research rather than direct caregiver services, though it may expand clinical-trial and treatment access for Texas families over time.2

Who Pays for Dementia Care in Texas

Texas Medicaid (STAR+PLUS)

For Texans who qualify, Medicaid STAR+PLUS is the main vehicle for in-home dementia care. Its Home and Community Based Services help people who would otherwise need nursing-home care stay at home, and they can include personal care, adult day services, and respite to give the family caregiver a break. Eligibility is income- and asset-tested and requires a nursing-facility level of care. Respite hours are arranged through the member's STAR+PLUS service coordinator.3

Getting Paid to Care for a Loved One With Dementia

Many Texas dementia caregivers can be paid for the care they provide, through Medicaid self-direction or, for veterans' families, VA programs. The pathways, who can be hired, and the pay are covered in detail in the Texas paid family caregiver guide.

VA Benefits (for Veterans)

If the person you care for is a veteran enrolled in VA health care, the VA's Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays the approved Primary Family Caregiver, who can be a spouse, a tax-free monthly stipend. PCAFC serves veterans with a VA disability rating of 70% or higher who need at least six months of continuous, in-person personal care, and it also provides caregiver training, counseling, and at least 30 days of respite care a year. The stipend is not a flat national figure: it is tied to the federal pay scale for the veteran's locality, so the amount depends on where the veteran lives. Separately, the VA Aid and Attendance benefit adds monthly payments to a VA pension for a veteran or surviving spouse who needs help with daily activities such as bathing and dressing, which can offset the cost of in-home or facility dementia care. Call the VA Caregiver Support Line at 1-855-260-3274.6

Medicare

Medicare covers dementia-related doctor visits and a separate cognitive assessment and care-plan visit, for which you pay 20% of the Medicare-approved amount after the Part B deductible, plus limited short-term skilled home health and hospice. It does not pay for long-term custodial care or a family caregiver's time. The GUIDE (Guiding an Improved Dementia Experience) Model, a voluntary nationwide Medicare program that began in 2024, adds dementia care navigation, a 24/7 support line, caregiver training, and up to $2,500 a year in respite for traditional-Medicare beneficiaries whose provider participates; ask your neurologist or the Alzheimer's Association helpline whether a GUIDE provider operates near you.7

Respite for Dementia Caregivers

Respite is not optional for dementia caregivers; it is what makes the long haul survivable. In Texas, respite comes from several places: STAR+PLUS for Medicaid-eligible members, the National Family Caregiver Support Program through your AAA (free, no income test), adult day programs, and the Take Time Texas respite locator. For the full picture, see Respite Care in Texas.3

A few days a week at a dementia-capable adult day program often does double duty: it gives you reliable hours back, and the structure, activity, and social contact frequently improve sleep, mood, and behavior for the person with dementia.

Safety, Behavior, and Planning

Dementia raises issues that other caregiving does not: wandering, driving, sundowning, and the legal and financial planning that needs to happen while your loved one can still participate. The Alzheimer's Association 24/7 Helpline (1-800-272-3900) can walk you through behavioral strategies and connect you to local resources, and the Alzheimer's Association offers a wandering-response and safety program. Early legal planning, a durable power of attorney, advance directives, and a long-term-care plan, is far easier done sooner than later.2

Learn More

Find personalized help caring for a loved one with dementia in Texas at brevy.com.

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.