GUIDE Model Delivers Critical Dementia Support

As the population of older Americans continues to grow, so does the number of families facing the complex, emotional challenge of caring for loved ones with dementia. At Right at Home, we’ve long understood that dementia is more than a clinical diagnosis—it’s a disruptive, often overwhelming experience for entire families. That’s why we’ve embraced the GUIDE Model, a new initiative from the Centers for Medicare & Medicaid Services (CMS) that is poised to change the landscape of dementia care nationwide.

The GUIDE Model—which stands for Guiding an Improved Dementia Experience—is the first CMS innovation designed specifically to support individuals with dementia and their caregivers through coordinated clinical services, respite care and caregiver education. We are proud to be participating in this historic model, which represents a major shift in how agencies like ours can work with Medicare to deliver better, more consistent care in the home setting.

One of the key benefits of participating in GUIDE is the opportunity to integrate virtual nursing and remote clinical support into existing care models. At Right at Home, we’ve seen how on-demand access to experienced nurses through secure platforms can extend the reach of our in-home caregivers, provide additional peace of mind to families and allow for more personalized care planning. Our selected partner for this program is PocketRN, whose virtual nursing platform offers 24/7 clinical support and continuity of care through its “Nurse for Life” system.

Through this partnership, eligible Medicare beneficiaries and their family caregivers can access 72 hours of respite care annually, in-home safety assessments and round-the-clock virtual nursing support—all at no cost.

The burden of care on family members is one of the greatest unspoken challenges in dementia support. Many caregivers are adult children or spouses who are balancing full-time jobs, parenting responsibilities and their own health concerns. Without consistent help, they face isolation, stress and exhaustion. The GUIDE Model acknowledges those pressures and offers solutions that are both clinically sound and logistically accessible.

The GUIDE Model is more than a new federal benefit—it’s a shift in how Medicare supports both those with dementia and the families caring for them through innovative relationships with homecare agencies that have long-standing trust in the community.

Mike Steiner, owner of Right at Home in Northern Lake County, Illinois, has seen the toll firsthand. 

“In my 12-plus years of experience, the majority of people who care for those living with dementia and call us for care are burned out, stressed out and not sure what to do,” Steiner said. “The fragmented health care system that those with dementia encounter is daunting. Cost for caring can be staggering and out of reach for many. This program will help give these caregivers some long-needed support … so they can recharge their batteries.”

This support is already making an impact. In Texas, Suzanne Taylor and her sister Donna Wardlow—who lives with dementia in a memory care facility—enrolled in the program earlier this year. Before GUIDE, Taylor drove 45 minutes each way to help manage her sister’s care. That strain was taking a toll.

“I was having to go over there so much… now someone’s coming regularly, and it gives me time to take care of other things,” Taylor said.

Today, Wardlow receives weekly visits from a Right at Home caregiver who organizes her belongings, facilitates engagement activities and helps her stay socially connected. For Suzanne, the biggest relief comes from knowing that the services are fully covered by Medicare. “This was a godsend,” she said. “Programs like this don’t just help the person with dementia—they help the whole family.”

As of this writing, more than 140 Right at Home franchisees have begun onboarding with the PocketRN Dementia Care Program, with 70 already live and active across numerous states. Right at Home’s role in the GUIDE Model is focused on in-home assessments and respite care delivery,  services that can make a tangible difference in a family’s ability to cope and plan.

The GUIDE Model is more than a new federal benefit—it’s a shift in how Medicare supports both those with dementia and the families caring for them through innovative relationships with homecare agencies that have long-standing trust in the community. By blending technology, in-person support and personalized coaching, we’re supporting a care environment that is proactive, not reactive. This is care that adapts as dementia progresses, care that supports both the person living with the condition and those who love them.

It’s rare to see a model that truly addresses the lived reality of caregiving. But that’s exactly what GUIDE aims to do. And at Right at Home, we are honored to help lead the way.