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Dementia affects millions of families, and too often the care leaves loved ones confused and overwhelmed. Families are juggling numerous appointments, trying to navigate complex care, and carrying the heavy emotional and financial weight of caregiving. To address these challenges, the Centers for Medicare & Medicaid Services (CMS) has launched a model under their Innovation Center: Guiding an Improved Dementia Experience (GUIDE), which is designed to bring more compassion, coordination, and support to families.
Why This Matters to Our Community
More than 160,000 family and friends are currently providing care for someone with dementia in San Diego/Imperial Counties[1]. Caregiving for someone with dementia is more than having a loved one with a medical condition; it is a daily care journey that impacts every part of life. Caregivers often report feeling exhausted and isolated. With structured support and resources that are aimed at easing the burden on caregivers and improving the quality of life for people with dementia, GUIDE is helping to change the conversation.
What is Guide?
GUIDE is a voluntary program that includes over 300 participating providers nationwide, ranging from health systems to community organizations. Many participating providers are offering care in the GUIDE model through telehealth to allow for care at times when they need it most. GUIDE providers are partnering with community-based organizations to deliver care services and offer a network of local resources.2
Your loved one may qualify for GUIDE if:
• Covered under traditional Medicare Part A & B, and NOT on a Medicare Advantage plan, PACE program, or currently receiving hospice care.
• Have a dementia diagnosis confirmed by a clinician.
• Living at home or in an independent or assisted living community (not in a nursing home/long-term care facility).
Benefits for Individuals with Dementia and their Caregivers
GUIDE offers services that go beyond traditional healthcare, offering wraparound support to families and their loved one. This support means better outcomes for patients, reduced stress for caregivers, and lower healthcare costs overall. For eligible Medicare beneficiaries, GUIDE is fully covered by Medicare, at no additional cost or co-pays for services.[2]
GUIDE benefits include:
- Access to a GUIDE provider 24/7 through a dedicated support line
- An assigned care navigator who can assist with coordinating appointments and connecting caregivers with local, supportive resources
- GUIDE care team will collaborate with existing care team members (PCP, Neurologist, etc) to enhance coordination of care
- Caregiver education and training to assist in making home a safe and supportive environment
- Annual respite services benefit of $2500 to provide family caregivers with a much-needed break (for eligible recipients)
These supports are designed to help families feel less alone and more empowered in their caregiving journey.
How to Find Out If You Are Eligible For GUIDE
Several organizations who participate in the San Diego Dementia Consortium are partnered with GUIDE providers to provide community-based services, including respite care. Home care agencies who have partnered with GUIDE participating providers can assist with eligibility questions. GUIDE participating providers in California can also be contacted directly for questions on eligibility.
A full list of GUIDE participating providers in California can be found at: www.cms.gov/priorities/innovation/innovation-models/guide
Looking Ahead
GUIDE is a game-changer for loved ones who are often lost in shadows while bearing the burdens of caregiving. GUIDE provides a lifeline that acknowledges the challenges of caregiving and offers tangible, coordinated, and real-world support. This model could reshape how we approach dementia care for the long-term and prove that when caregivers are supported, patients thrive, and communities benefit.
Kimberly McDonough is the Director of Community Relations for Visiting Angels Central San Diego, a GUIDE model partner in San Diego: www.visitingangels.com/centralsandiego/guide-model
[1] Alzheimer’s Association. (n.d.). San Diego/Imperial Chapter. Alzheimer’s Association. Retrieved December 1, 2025, from alz.org/sandiego
[2] Centers for Medicare & Medicaid Services. (2025, November 24). GUIDE (Guiding an Improved Dementia Experience) Model. CMS. Retrieved December 1, 2025, from www.cms.gov/priorities/innovation/innovation-models/guide