Download Respite Application
Click to download an application for the Alzheimer's Association, Connecticut Chapter Respite Program. Contact the Chapter for more information at (800) 272-3900.
Connecticut Chapter Respite Application (PDF)
The Connecticut Statewide Respite Care Program is funded by the State Department on Aging and is operated in partnership with the Alzheimer's Association Chapters of Connecticut and the Connecticut Area Agencies on Aging. Eligible families may apply for daytime or overnight respite care services including but not limited to: Adult day care, home health aide, homemaker/companion, skilled nursing care, self-directed care, Cognitive Training, or short term nursing home placement. Contact the Area Agencies on Aging for an application: 1-800-994-9422.
The applicant or authorized agent must provide a Physician's statement declaring that the patient has Alzheimer's disease or a related disorder such as: Multi-Infarct dementia, Parkinson's Disease, Lewy Body Dementia, Huntington's disease, Pick's disease or Normal Pressure Hydrocephalus. The applicant cannot be receiving services under the Connecticut Home Care Program for Elders (CHCPE), must have an income of no more than $41,000 per year and liquid assets of $109,000 or less. The program pays for up to $7,500 in respite care services per family per year. A 20% co-payment of the cost of the service is required, but may be waived based upon financial hardship.
The Alzheimer's Association Respite Fund, subsidized from individual and corporate donations to the Association, is a financial reimbursement program designed to assist caregiving families in accessing respite care services. It provides up to $500 per family per year. Eligible families may purchase any of the following respite care services: adult day care, home health aide, adult foster care, homemaker/companion, skilled nursing care or short term nursing home care. Funds may be used for daytime or overnight respite. It is the family's responsibility to arrange for respite care services. Resource lists of providers are available from the Chapter. Reimbursement will be made directly to the service provider after receipt of purchase is submitted to the Chapter. At the present time there is a waiting list.
Respite care is a service designed to provide a break, or a time of caregiver relief, from the physical and emotional stress of caring for a person with Alzheimer's disease or a related disorder. Family caregivers generally find that the task of caring for a person with dementia is overwhelming. They often develop stress-related illnesses such as heart disease, hypertension, or ulcers. An occasional break from caregiving enables an exhausted caregiver to regroup, both physically and emotionally, and find the strength to carry on. Respite care is an invaluable service that truly saves caregiver lives. With financial assistance, many family caregivers who would not otherwise use this service will have the opportunity to obtain temporary relief for themselves, and may be able to care for their Alzheimer's loved ones at home much longer than would otherwise be possible.
reside with the person with dementia;
live in Connecticut;
complete an application form;
provide a statement from a physician that the patient has Alzheimer's disease or a related disorder;
utilize a respite service;
the individual with dementia can not be on Title XIX/Medicaid;
Preference is given to applicants who are not accessing other respite services.