GUIDE Program: Transforming Dementia Care at Home
Mobile Medical Selected by Centers for Medicare & Medicaid Services to Test Medicare Dementia Care Model
Guiding an Improved Dementia Experience (GUIDE) Model Aims to Increase Care Coordination, Support for Caregivers
Today, Mobile Medical announced they have been selected by the Centers for Medicare & Medicaid Services (CMS) to participate in a new Medicare alternative payment model designed to support people living with dementia and their caregivers. Under CMS’ Guiding an Improved Dementia Experience (GUIDE) Model, Mobile Medical will be one of almost 400 participants building Dementia Care Programs (DCPs) across the country, working to increase care coordination and improve access to services and supports, including respite care, for people living with dementia and their caregivers.
“CMS is excited to partner with Mobile Medical under the GUIDE Model,” said CMS Administrator Chiquita Brooks-LaSure. “GUIDE is a new approach to how Medicare will pay for the care of people living with dementia. The GUIDE participants are envisioning new ways to support not only people living with dementia, but also to reduce strain on the people who care for them, so that more Americans can remain in their homes and communities, rather than in institutions.”
Launched on July 1, 2024, the GUIDE Model will test a new payment approach for key supportive services furnished to people living with dementia, including: comprehensive, person-centered assessments and care plans; care coordination; 24/7 access to an interdisciplinary care team member or help line; and certain respite services to support caregivers. People with dementia and their caregivers will have the assistance and support of a Care Navigator to help them access clinical and non-clinical services such as meals and transportation through community-based organizations.
Mobile Medical was established in 2010, and leads the industry as a Primary Care House Calls Practice. Established as an innovative solution to a fragmented healthcare system, Mobile Medical believes that quality care should be personalized, affordable and accessible to everyone for optimal health and wellness. In the ever-changing landscape of complex healthcare, Mobile Medical is making a difference in the lives of patients/caregivers, by simplifying access to primary care.
Mobile Medical’s participation in the GUIDE Model will help people living with dementia and their caregivers have access to education and support, such as training programs on best practices for caring for a loved one living with dementia. The GUIDE Model also provides respite services for certain people, enabling caregivers to take temporary breaks from their caregiving responsibilities. Respite is being tested under the GUIDE Model to assess its effect on helping caregivers continue to care for their loved ones at home, preventing or delaying the need for facility care.
GUIDE Participants represent a wide range of health care providers, including large academic medical centers, small group practices, community-based organizations, health systems, hospice agencies, and other practices.
This model delivers on a promise in the Biden Administration’s Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers and aligns with the National Plan to Address Alzheimer’s Disease. For more information on CMS’ GUIDE Model, please visit: https://www.cms.gov/priorities/innovation/innovation-models/guide.
Empowering Patients, Supporting Caregivers, and Strengthening Communities
At Mobile Medical , we are proud to introduce the GUIDE Program —a groundbreaking initiative designed to improve the quality of life for individuals living with dementia while providing much-needed support for their caregivers. As one of only 390 organizations nationwide selected by CMS to participate in this innovative model, Mobile Medical is committed to delivering compassionate, comprehensive care that keeps patients independent, reduces caregiver stress, and fosters a brighter future for families.
The GUIDE Program is an 8-year model being tested by CMS through June 30, 2032. Our mission is clear: enhance dementia care, reduce unnecessary healthcare usage, and help patients remain in the comfort of their homes and communities longer.
Why GUIDE Matters
Before GUIDE, older adults with dementia and their caregivers struggled with fragmented support systems, limited transportation options, medication oversight gaps, and caregiver exhaustion.
With GUIDE, seniors with dementia gain access to tailored care coordination and reliable transportation, while their caregivers receive essential training and respite opportunities.
This integrated approach has helped families reduce their reliance on costly institutional care and preserve independence for their loved ones, who can remain in their own homes.
This is the power of GUIDE.
Personalized Care Plans
Custom strategies to simplify daily tasks and maximize independence for dementia patients, ensuring tailored care that meets individual needs.
24/7 Access to Care Teams
Around-the-clock support from your primary care provider and specialized dementia care navigators, ensuring peace of mind for patients and caregivers.
Comprehensive Resource Coordination
Access vital resources including transportation, specialist referrals, and community services, coordinated by our dedicated care navigators.
Caregiver Education & Support
Equip caregivers with the tools and techniques needed to manage symptoms and reduce stress through our partnership with the Botes Memory Method.
Explore the GUIDE Program
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Personalized Care Plans to Empower Independence
Living with dementia can be challenging, but you don’t have to face it alone. The GUIDE Program offers tailored solutions to simplify daily tasks, manage symptoms, and maximize independence.
What We Provide:
- Comprehensive Neuro Cognitive Assessment: Tailored evaluations to understand individual needs.
- Personalized Dementia Care Planning: Custom strategies to simplify daily routines and foster independence.
- 24/7 Access to Your Care Team: Immediate support whenever you need it.
- Ongoing Monitoring & Support: Guided by specialized dementia care navigators.
- Medication Management: Ensuring safety and consistency in treatment.
- Care Coordination: Connecting you to vital resources like Meals on Wheels, transportation, and specialist referrals.
Eligibility Requirements:
To qualify for the GUIDE Program, patients must meet the following criteria:
- Diagnosed with dementia.
- Enrolled in Medicare Parts A & B.
- Not enrolled in Medicare Advantage.
- Have Medicare as their primary payer.
- Not enrolled in PACE (Program of All-Inclusive Care for the Elderly).
- Not enrolled in Hospice.
- Not a long-term nursing home resident.
Let us help you stay independent longer.
Support That Reduces Stress and Builds Confidence
Caring for a loved one with dementia can be overwhelming. The GUIDE Program provides caregivers with tools, training, and respite services to ensure they feel empowered and supported every step of the way.
What We Offer:
- Caregiver Education & Training: Partnering with the Botes Memory Method to equip caregivers with practical techniques to manage symptoms and reduce stress.
- Respite Services Coordination: Providing breaks through in-home care, Adult Daycare, or overnight stays in Assisted Living Facilities (ALFs).
- Emotional & Practical Support: Monthly in-person home visits and ongoing communication with care navigators and providers.
Why It Matters:
With our support, caregivers can avoid burnout, maintain their well-being, and continue providing loving care to their loved ones.
Collaborative Care That Enhances Outcomes
Partnering with Mobile Medical means gaining access to a network of specialized dementia care navigators and innovative tools to enhance patient outcomes.
Benefits of Partnership:
- Access to Specialized Resources: Collaborate with our team of dementia care navigators to develop personalized care plans.
- Streamlined Care Coordination: Connect patients to community-based services like Meals on Wheels, transportation, and adult day centers.
- Opportunities for Growth: Expand your impact through innovative care models and potential revenue opportunities via CMS funding for respite services.
Together, we can create a brighter future for patients and their families.
Strengthening Community Connections Through Collaboration
Facilities play a vital role in supporting individuals with dementia and their caregivers. The GUIDE Program helps facilities integrate clinical and support services to meet health-related social needs.
How We Help:
- Community Resource Integration: Partner with us to connect patients to essential services like Meals on Wheels, transportation, and adult day centers.
- Respite Services for Patients: Coordinate overnight stays in Assisted Living Facilities (ALFs) or Adult Daycare programs.
- Enhanced Care Models: Strengthen your facility’s impact by participating in innovative care initiatives backed by CMS.
Join us in building stronger, more supportive communities.
About Dementia
What is Dementia?
Dementia is a broad term used to describe a decline in cognitive function that is severe enough to interfere with daily life and activities. It is not a specific disease but rather a collection of symptoms caused by damage to brain cells that affects thinking, memory, reasoning, and behavior.
Common Types of Dementia
- Alzheimer’s Disease: The most common form, accounting for 60-80% of cases. It typically begins with memory loss and progresses to affect language, decision-making, and daily function.
- Vascular Dementia: Caused by reduced blood flow to the brain, often following a stroke or series of mini-strokes.
- Lewy Body Dementia: Involves abnormal protein deposits (Lewy bodies) in the brain, causing cognitive decline along with movement and mood changes.
- Frontotemporal Dementia: Affects the frontal and temporal lobes of the brain, often leading to changes in personality, behavior, and language.
- Mixed Dementia: A combination of two or more types of dementia, often Alzheimer’s and vascular dementia.
What Causes Dementia?
Dementia is caused by damage to brain cells that affects their ability to communicate with one another, leading to cognitive decline. The specific cause of dementia depends on the type, but several factors can contribute to this brain damage.
Common Causes of Dementia:
Alzheimer’s Disease:
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- Caused by abnormal deposits of beta-amyloid plaques and tau tangles that build up in the brain, damaging nerve cells and disrupting communication.
- The exact cause is not fully understood but is believed to involve a combination of genetics, lifestyle, and environmental factors.
Vascular Dementia:
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- Results from reduced blood flow to the brain due to strokes, mini-strokes, or other conditions that damage blood vessels.
- Blocked or damaged blood vessels deprive brain cells of oxygen and nutrients, leading to cognitive decline.
Lewy Body Dementia:
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- Caused by the buildup of abnormal protein deposits called Lewy bodies in the brain.
- These deposits affect chemicals in the brain that can lead to changes in thinking, movement, and behavior.
Frontotemporal Dementia (FTD):
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- Results from degeneration of the frontal and temporal lobes of the brain.
- It is often linked to abnormal protein buildup, including tau and TDP-43 proteins, which damage brain cells.
- FTD often occurs earlier than other forms of dementia, usually between ages 40 and 65.
Mixed Dementia:
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- Involves a combination of two or more types of dementia, most commonly Alzheimer’s and vascular dementia.
- This combination can lead to a more rapid decline in cognitive function.
Other Contributing Factors:
- Traumatic Brain Injury (TBI): Repeated head trauma, often seen in athletes or military personnel, can increase the risk of developing dementia.
- Infections or Immune System Disorders: Conditions such as meningitis, encephalitis, or autoimmune diseases can cause inflammation and damage to brain tissue.
- Metabolic or Endocrine Disorders: Conditions like hypothyroidism, low blood sugar, or vitamin deficiencies (B12, folate) can lead to cognitive decline that may mimic dementia.
- Toxic Exposure: Prolonged exposure to heavy metals, alcohol, or drugs can damage brain cells and contribute to cognitive decline.
Early Signs and Symptoms
- Memory loss that disrupts daily life
- Difficulty with problem-solving or planning
- Confusion with time or place
- Difficulty with words, speaking, or writing
- Misplacing items and inability to retrace steps
- Changes in mood, personality, or behavior
Risk Factors
- Age (risk increases with age, especially after 65)
- Family history and genetics
- Cardiovascular conditions (high blood pressure, diabetes, etc.)
- Lifestyle factors (poor diet, lack of exercise, smoking)
Treatment and Management
While there is no cure for most forms of dementia, treatment focuses on managing symptoms and slowing progression. Medications, cognitive therapies, physical and occupational therapy, and lifestyle changes can help improve quality of life.
Are you concerned that you or a loved one may exhibit some of the early warning signs of Dementia? Book an evaluation with us to determine your risk, and if necessary, your optimal treatment plan.
Early intervention can help to slow disease progression.
Join the GUIDE Program Today
Discover how the GUIDE Program can enhance the quality of life for those living with dementia. Contact Mobile Medical to learn more about our innovative approach and how we can support you and your loved ones.
Call us at 877-844-0053
Patients & Caregivers
Explore comprehensive care plans designed to enhance the quality of life for dementia patients and offer essential support to caregivers. Tailored assessments and 24/7 access to care teams ensure personalized attention.
Facilities
Implement the GUIDE Program in your facility to provide cutting-edge dementia care. Benefit from specialized training, resource coordination, and support services that enhance patient outcomes and caregiver satisfaction.
Providers
Partner with Mobile Medical to deliver exceptional dementia care through the GUIDE Program. Access tools and resources that empower providers to offer personalized care plans and continuous support for dementia patients.
Additional Resources
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