Maryland Dementia Family Meeting Template: How to Structure the Conversation

The hardest part of dementia caregiving in Maryland usually isn't navigating the Medicaid system or finding a memory care facility. It's getting your siblings in the same room and leaving with an actual plan instead of an argument.

Family meetings about a parent's care derail for predictable reasons: no agenda, no data, and no one who's done the homework to separate opinion from fact. This template gives you a structure that works, grounded in the specific decisions Maryland families face.

Before the Meeting: Preparation Checklist

The meeting itself is the easy part. The preparation is what determines whether it produces decisions or just circular arguments.

Gather current documents. Before the meeting, confirm whether the following exist and are current:

• Maryland Statutory Form Personal Financial Power of Attorney (Estates & Trusts § 17-202)
• Maryland Advance Directive (Health-General § 5-603)
• A recent medical assessment documenting cognitive status
• Current bank and investment account statements
• Insurance policies (Medicare, Medigap, long-term care insurance if any)

If the POA and Advance Directive don't exist, that becomes the first action item — they must be completed while your parent still has capacity to sign. If you're unsure about capacity, that's a question for the physician, not the family.

Run the numbers. Calculate your parent's monthly income (Social Security, pension, investment income) and total countable assets (bank accounts, retirement accounts, investments — excluding the primary home, one vehicle, and irrevocable burial contracts). Compare against Maryland's key thresholds:

• Community Options Waiver income cap: $2,982/month
• Medicaid asset limit: $2,000 or $2,500, depending on the program and eligibility category
• SOAR program income limit: $4,358/month, asset limit: $20,064

Having these numbers on paper prevents the meeting from stalling on "I think Mom has about..." statements.

Invite the right people. Include all siblings and any other family members who will be involved in caregiving or financial decisions. If your parent is in the early stages and wants to participate, include them — their preferences should drive the plan. If you anticipate serious conflict, consider hiring a geriatric care manager to facilitate. Maryland's Area Agencies on Aging can also recommend local mediators.

Meeting Agenda: Five Decision Blocks

Structure the meeting around these five topics, in this order. Assign a timekeeper — 15 to 20 minutes per block keeps the conversation moving.

Block 1: Current Situation Assessment

Start with facts, not opinions. Review:

• What is the formal diagnosis, and what stage is it?
• What can your parent still do independently? What requires help?
• Have there been any safety incidents (wandering, falls, medication errors, stove left on)?
• Is the current living situation sustainable for the next 6 months? 12 months?

The goal is to get everyone working from the same set of facts. If siblings disagree about the severity, reference the most recent medical assessment. The interRAI evaluation through Maryland's AERS program provides an objective clinical measure if the family needs one — and it's free.

Block 2: Legal and Financial Status

Walk through the documents and numbers you prepared:

• Are the POA and Advance Directive current and naming the right agents?
• What is the total financial picture, and how long will it sustain private-pay care?
• Has anyone consulted an elder law attorney about Medicaid planning?
• Is the family aware of the 60-month look-back rule?

This block often surfaces the most tension, because it forces the conversation about who pays for what. Be direct about it. If one sibling has been the primary caregiver, that labor has economic value — Maryland's Community First Choice and consumer-directed programs can even pay family caregivers through Medicaid in some cases.

Block 3: Care Responsibilities

This is where you assign roles. Unassigned responsibilities default to whoever lives closest, which breeds resentment. Divide the work explicitly:

• Primary care coordinator: The person who manages appointments, communicates with providers, and tracks medications
• Financial manager: The person handling bills, insurance claims, and Medicaid paperwork (ideally the POA agent)
• Research lead: The person investigating facility options, waiver programs, and local resources
• Respite backup: Who steps in when the primary caregiver needs a break, and how often?

For families where siblings are geographically scattered, remote siblings can take on research, financial management, and scheduling tasks. The local sibling shouldn't be doing everything.

Block 4: Housing and Care Trajectory

Don't make a residential decision today — plan for the decision points ahead:

• Current plan: What changes are needed to keep your parent safe at home for the next 6 to 12 months? (Home modifications, GPS tracking, in-home care?)
• Trigger events: What specific events would signal that home is no longer safe? Document these now so you're not debating them during a crisis.
• Facility research: Who will research memory care options, request the ASCU Disclosure Forms, and tour facilities?
• Waitlist registration: Has anyone contacted Maryland Access Point to register for the Community Options Waiver? If not, this is an immediate action item.

Block 5: Action Items and Next Meeting

End every meeting with a written list of who is doing what by when. Vague commitments don't get done.

Sample action items:

• [ ] Complete POA and Advance Directive by [date] — assigned to [name]
• [ ] Call MAP at 1-844-627-5465 to register for HCBOW — assigned to [name]
• [ ] Request AERS evaluation — assigned to [name]
• [ ] Consult elder law attorney re: Medicaid planning — assigned to [name]
• [ ] Tour three memory care facilities and request Disclosure Forms — assigned to [name]
• [ ] Set up Project Lifesaver enrollment — assigned to [name]

Schedule the next meeting before everyone leaves. Monthly meetings during active planning, quarterly once a care plan is in place.

When the Meeting Stalls

Two common impasses and how to break them:

"Mom would never want to go to a facility." This statement shuts down planning. Reframe it: "What would need to be true for Mom's current situation to become unsafe?" Document specific, observable triggers (leaving the house at night, refusing medications, inability to recognize family members). When those triggers occur, the decision has already been made.

"We can't afford care." This is almost always based on incomplete information. Most families haven't explored Medicaid waiver coverage, the SOAR subsidy, VA Aid & Attendance, or the 30-day Medicaid-paid nursing-facility bypass that skips the multi-year waitlist. Assign someone to research the actual options before the next meeting.

The Maryland Dementia & Memory Care Guide includes a family meeting worksheet with these decision blocks pre-formatted, plus the financial worksheets and facility audit checklists that make each meeting productive rather than circular.

See more Maryland guides →