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Dementia Support Program

Dementia Support Program for Patients & Caregivers

AMG’s is one of a few programs nationwide to participate in this & one of only 4 local participants provides comprehensive dementia care coordination plus caregiver education, support, and (for qualifying families) respite services through Medicare's GUIDE Program —so you don’t have to navigate this alone.

GUIDE is a CMS Innovation Center model that expands Medicare coverage for dementia care coordination and caregiver support.

What is GUIDE?

GUIDE (Guiding an Improved Dementia Experience) is a national Medicare model designed to improve quality of life for people living with dementia and reduce caregiver strain through team- based care coordination, ongoing caregiver support, and access to respite services for qualifying caregivers.

At AMG, our goal is simple: make dementia care more organized, proactive, and supportive— for both the patient and the caregiver.

Who is this program for?

GUIDE is for confusion? Medicare fee-for-service beneficiaries living with dementia.

You may benefit if you or your loved one:

Has a diagnosis of Alzheimer’s disease or another dementia

Lives at home or in a assisted living facility

Has a family member or unpaid support person involved (explained below)

What families receive through AMG’s GUIDE program

1) A dementia care navigator + interdisciplinary team

You’ll have a consistent point of contact to help coordinate care, answer questions, and connect you to resources—backed by an interdisciplinary dementia care team.

2) A dementia-focused care plan

We create and update a personalized care plan that addresses dementia symptoms, safety needs,
caregiver goals, and co-occurring conditions—then help coordinate care across your medical team and community supports.

3) Caregiver education + ongoing support

Caregivers receive ongoing support, monitoring, and guidance—including access to help when questions come up.

4) 24/7 support line

GUIDE includes 24/7 access to a support line for caregivers/patients for urgent guidance and needs.

5) Respite services for qualifying caregivers

Some families may qualify for respite services providing temporary relief via options like in-home respite, adult day services, or short-term facility-based respite (availability varies locally).

Why this matters

Dementia is not just memory loss—it affects function, safety, medication management, behavior, caregiver wellbeing, and long-term planning. GUIDE is built to reduce avoidable crises and improve support over time.

How to get started

GUIDE (Guiding an Improved Dementia Experience) is a national Medicare model designed to improve quality of life for people living with dementia and reduce caregiver strain through team- based care coordination, ongoing caregiver support, and access to respite services for qualifying caregivers.

Families & caregivers

  1. Click Request a GUIDE Consult
  2. Our team will contact you to confirm eligibility and next steps
  3. If aligned, we’ll schedule your intake and begin care planning

Providers, facilities, and community partners

What to include in a referral (helpful):

  • Dementia diagnosis (if known) and current living setting
  • Caregiver contact info (if available)
  • Top concerns (falls, meds, behaviors, caregiver burnout, safety)

Frequently Asked Questions

Does GUIDE cost anything?

No. Costs are covered by Medicare with no out of pocket costs.

Is respite available for everyone in GUIDE?

Respite is available for qualifying caregivers (is re-evaluated periodically when support is needed).

Do you replace the patient’s primary care provider?

No—GUIDE is designed to coordinate dementia-focused care and caregiver supports, and to partner with the patient’s existing clinicians and community resources.

What kinds of dementia are included?

All types of dementia & cognitive changes can be supported.

What if we don’t have a caregiver?

GUIDE is built around supporting patients and unpaid caregivers, and caregiver involvement impacts what services (like respite) may be available. We can still talk through your situation and resources.

Ready for support?

If dementia is affecting daily life, safety, or caregiver stress, AMG’s GUIDE team can help.

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