Dementia Care Plan Checklist for Maryland Families

The First 30 Days After Diagnosis

A dementia diagnosis creates an urgent planning window. The parent still has cognitive capacity, legal documents can still be signed, and the family has time to learn Maryland's systems before a crisis forces reactive decisions. Here is what to prioritize and in what order.

Week 1: Secure legal authority. Execute a durable financial power of attorney (Estates and Trusts § 17-202) and a Maryland advance directive (Health-General § 5-603) immediately. Both require the parent to understand the document and the authority or choices it records at the moment of signing. This capacity will decline — possibly gradually, possibly in sudden steps — and once it is gone, these documents cannot be created. The only remaining option at that point is court-ordered guardianship, which costs thousands of dollars and takes weeks to months.

Week 2: Assess safety at home. Walk through the parent's living environment with fresh eyes. Check for unlocked exterior doors the parent could wander through, accessible stove controls, tripping hazards, medications stored where the parent could double-dose, and car keys. If the parent is still driving, evaluate driving ability honestly — a formal driving assessment through an occupational therapist provides objective documentation.

Week 3: Call Maryland Access Point. Dial 1-844-627-5465 to initiate the Level One Screening. This free telephone assessment evaluates your parent's daily functioning and cognitive indicators. If the screening suggests a need for services, MAP routes the case to the local health department's AERS program for a comprehensive in-home evaluation. Starting this process early — even if your parent does not currently need services — gets them into the state's LTSSMaryland database and positions them for program enrollment when the time comes.

Week 4: Organize financial records. Gather bank statements, investment accounts, retirement accounts (IRAs and 401ks are fully countable in Maryland), life insurance policies, property deeds, and the parent's Social Security benefit statement. These records can support funding applications for Medicaid, VA Aid and Attendance, or the SOAR program. A complete financial picture also reveals how many months of private-pay care the parent's assets can sustain.

The First Six Months: Financial and Program Planning

Start the Medicaid look-back clock. Maryland applies a 60-month (five-year) look-back period on asset transfers when evaluating Medicaid eligibility. Uncompensated asset transfers or gifts made within this window trigger a penalty period during which Medicaid will not pay for care. If there are assets to restructure — paying off the mortgage, funding irrevocable burial trusts, making home modifications — doing it early gives those transactions time to clear the look-back period.

Identify which Medicaid pathway fits. Maryland operates several distinct programs with different income limits, asset limits, and clinical requirements:

• Community First Choice (CFC): home-based care, no waitlist, income limit of $350/month (or medically needy spend-down)
• Community Options Waiver (HCBOW): covers care in assisted living, income cap of up to $2,982/month, and a registry that had 24,015 people in early 2025
• SOAR: for those over Medicaid limits but within the $4,358/month individual income and $20,064 individual countable-asset limits

Understanding which pathway your parent will likely need — and whether their income and assets currently qualify — shapes every financial decision between now and the application date.

Register for the HCBOW waitlist if eligible. If your parent's income is up to $2,982/month and they meet the nursing facility level of care, contact MAP to be placed on the HCBOW registry. The waitlist is measured in years, so registering early maximizes the chance of receiving an invitation to apply before the parent needs placement.

Evaluate VA benefits. If the parent is a wartime veteran or a surviving spouse, the Aid and Attendance pension can provide up to $2,874/month (veteran with spouse). The application uses VA Form 21P-527EZ for a veteran or VA Form 21P-534EZ for a surviving spouse. Confirm current processing times and effective-date rules with the VA or a VA-accredited representative.

Ongoing: Care Coordination and Safety

Enroll in a wandering prevention program. If the parent shows any signs of spatial confusion or exit-seeking behavior, register with Project Lifesaver (available in Frederick, Washington, St. Mary's, and other participating counties) or invest in a GPS tracking device. Maryland's Silver Alert system activates for missing seniors with dementia, but prevention is faster than recovery.

Use the state's screening tools. The AD:8 Dementia Assessment Tool (an 8-question screening available through MAP) helps track cognitive changes over time. The Johns Hopkins Memory Care Family Checklist, launched in January 2026, generates personalized recommendations for home safety, medical needs, and emotional support based on your specific caregiving situation.

Connect with the Family Caregiver Support Program. Your local Area Agency on Aging administers respite care grants, caregiver training sessions, and support group referrals through the federally funded National Family Caregiver Support Program. The program serves caregivers of individuals aged 60+ or individuals of any age diagnosed with Alzheimer's disease or a related dementia; ask the local agency about eligibility and service availability.

Schedule regular family updates. Disagreements among siblings about care decisions are one of the most common sources of stress for primary caregivers — and one of the most common triggers for contested guardianship proceedings. A structured monthly update (even a brief email summarizing the parent's condition, upcoming decisions, and financial status) keeps all family members informed and reduces the chance of a sibling blindsiding the process.

When the Plan Needs to Change

The care plan you build after diagnosis will need revision. Dementia is progressive, and the supports that work at one stage become inadequate at the next. The planning sequence — legal documents, then safety measures, then financial structuring, then program enrollment, then facility evaluation — is designed to be completed in order but revisited as the disease advances.

The Maryland Dementia & Memory Care Guide covers each stage of this sequence with the specific Maryland forms, financial thresholds, and program details, organized as a planning roadmap rather than disconnected state agency pages.

See more Maryland guides →