Dementia care options in Fresno
There is no single right place for someone with dementia. The best fit depends on the stage, how safe they are at home, and how much help your family can give. Most families move through more than one option over time.
Here are the main choices in Fresno, Clovis and the nearby Valley towns, from the lightest help to the most.
| Type of care | Often a good fit when | Rough Fresno cost |
|---|---|---|
| In-home care (agency) | Early stage, still safe at home with family nearby | Around $30 to $36 an hour |
| Adult day program | Early to middle stage, and the family caregiver works or needs a break | Varies by program, ask each one |
| Board and care home | Middle stage, needs close watching in a small, quiet home | From about $3,700 a month, more for heavier care |
| Assisted living | Early stage, mild memory loss, still fairly independent | About $5,100 to $6,600 a month |
| Memory care | Middle to late stage, wandering, or needs a secured setting | Often $7,000+ a month |
| Skilled nursing | Late stage with daily medical or nursing needs | Medi-Cal may cover it for those who qualify |
Board and care homes are often overlooked. Many are regular houses in Fresno neighborhoods with six or fewer residents. Some take dementia residents and do it very well. Others do not, so always ask. You can read more on our memory care in Fresno page.
How to choose by stage
Dementia usually gets worse slowly. What works today may not work in a year. It helps to know roughly where your mom or dad is right now. Our guide to the stages of dementia walks through each one.
- Early stage: Forgetting recent things, repeating questions, trouble with bills. In-home help, adult day or assisted living can work well.
- Middle stage: Needs help dressing and bathing, gets lost, may have evening confusion (sundowning) or try to leave the house (wandering). This is when most families look at memory care or a board and care home that handles dementia.
- Late stage: Needs help with almost everything, including eating and moving. Memory care, a skilled board and care home, or skilled nursing. Hospice can be added in any of these settings.
If you are not sure yet what you are dealing with, start with the early signs of dementia and get a doctor's evaluation. It also helps to know the difference between Alzheimer's and dementia, since the type can change what kind of care works best.
California's rules for dementia care in licensed homes
In California, assisted living homes and board and care homes are licensed as Residential Care Facilities for the Elderly (RCFEs) by the California Department of Social Services (CDSS). If a home accepts or keeps residents with dementia, it must follow extra rules in Title 22, Section 87705.
Some of what those rules require:
- Staff trained in dementia care, including hydration, nutrition, communication and handling behavior changes.
- Door alarms or other alert devices on exterior doors and gates for residents who may wander.
- Delayed-exit door locks only with state approval and fire clearance, and never as a stand-in for enough staff.
- Awake night staff when residents with dementia need it.
- Space where residents can walk and wander freely and safely.
California law also sets training hours. Direct care staff in an RCFE need 40 hours of training when they start, with 12 of those hours on dementia care. After that, they need 20 hours a year, with 8 hours on dementia.
A home that advertises special dementia care must also follow Section 87706. It has to describe its dementia program in its plan of operation, including staff training, activities, and safety features, and make that description available to the public. Ask to see it on your tour.
Tell us what's going on. We'll text you licensed homes that fit, with real prices, and tour them with you.
What dementia care costs, and who pays
Cost is usually the hardest part. The numbers in the table above are what we see in Fresno today. Care for dementia often costs more than regular assisted living because it takes more staff time.
Medicare does not pay for long-term custodial care, like help with bathing and dressing in assisted living or memory care. Most families pay from savings, a home sale, or long-term care insurance. Veterans and surviving spouses may qualify for VA Aid and Attendance. Some people qualify for Medi-Cal programs. Our page on paying for senior care covers each one.
Alzheimer's in California
You are far from alone. The Alzheimer's Association estimates that about 719,700 Californians age 65 and older have Alzheimer's dementia, and about 1.4 million family members and friends in California care for someone with dementia without pay. Source: 2026 Alzheimer's Disease Facts and Figures.
How we help Fresno families
Our help is free to families. The licensed care homes pay us a referral fee when someone moves in, and we tell every family that up front.
- We listen first: the stage, the behaviors, the budget, and what matters most to your mom or dad.
- We only work with state-licensed homes, and we check each home's CDSS inspection record before we suggest it.
- We ask the hard questions for you: dementia training, night staff, door alarms, and what happens if care needs grow.
- We tour homes with you, so you are not doing this alone.
Caring for someone at home for a while longer? Our guide to dementia caregiver support in Fresno lists free local help, from respite to support groups.
Updated September 2026 by Shaun and Nick, co-founders of CalValley Senior Living Advisors.