A GUIDE to caring for older adults with dementia
An 89-year-old woman uses an adult coloring book to reduce anxiety and improve brain function in Dover, Delaware. Matthew Lovette/Jumping Rocks/Universal Images Group via Getty Images
The federal program looks to support older adults aging in place and their caregivers, which could help reduce state Medicare and Medicaid expenditures.
Dementia affects 1 in 9 Americans age 65 and older—an estimated 6.7 million people. Unfortunately, that number is expected to explode. By 2060, experts project 14 million Americans will be living with the syndrome.
The costs of caring for those with dementia are similarly expected to escalate. Millions of families already face daunting choices as the expenses of in-home care, assisted-living facilities and nursing homes devour their and their loved ones' savings.
To get ahead of the wave, the U.S. Department of Health and Human Services announced last week a new federal initiative that aims to standardize neurodegenerative health care for older adults across the U.S., support their caregivers, and reduce Medicare and Medicaid expenditures.
The federal Guiding an Improved Dementia Experience, or GUIDE, model looks to improve care coordination for patients with dementia, reduce strain on unpaid caregivers like patients’ family members and help older adults age in place, said U.S. Secretary of Health and Human Services Xavier Becerra on a Monday call with reporters. It is slated to run for eight years.
Nearly 400 organizations nationwide, ranging from academic medical centers to small group practices, are partnering with the Centers for Medicare and Medicaid to implement GUIDE. The model directs participating organizations, or providers and suppliers enrolled in Medicare Part B, to offer patients person-centered assessments and care plans, seamless care coordination across resources and 24/7 access to a support line for caregivers.
Caregivers will have access to respite services and educational and training resources so they can better understand the needs of those with dementia, an umbrella term used to describe a group of symptoms affecting memory, thinking and social abilities. Organizations must also pair patients and their caregivers with care navigators to help link them with additional supports, such as meal or transportation assistance.
“We know that people with dementia often have multiple chronic conditions, and as a result, can receive fragmented … care,” said CMS Administrator Chiquita Brooks-LaSure. “This results in poor outcomes and duplicative services [and] also leads to substantial financial burden, increased caregiving demands and mental health strains for those caring for someone with dementia.”
Recognizing health care access is more difficult for marginalized populations and can worsen long-term health disparities, Brooks-LaSure added that a quarter of participants serve rural residents, and one-third operate in areas serving low-income communities.
Officials said they expect the program to help more than 200,000 Medicare beneficiaries, who could also be dually enrolled in Medicaid. Enabling more older adults to receive adequate care at home will help reduce hospitalizations, emergency department visits and dependence on post-acute or nursing home care, easing the cost burden for government payers.
The GUIDE model follows other initiatives announced earlier this year by the Biden administration to address older adult health care, such as releasing a national plan on aging and issuing rules on nursing home staffing minimums.
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