Guiding an Improved Dementia Experience (GUIDE) Model

Information for Participants & Caregivers

What is GUIDE?

The GUIDE program offers enhanced services for dementia care and support for caregivers (a relative or unpaid nonrelative who helps with activities of daily living). The goals of GUIDE are to:

Improve the quality of life for people living with dementia.

Enhance support for caregivers of people living with dementia.

Help people living with dementia stay in their homes and communities longer.

Services for People Living with Dementia & Their Caregivers

Comprehensive Assessment & Care Plan

Get an assessment to identify your individual health needs and to build a care plan that is tailored to provide the services you need.

Caregiver Support

A relative or unpaid nonrelative who helps as a caregiver can receive education and support such as direct communication with a care navigator when they need it. 

GUIDE Respite Services

GUIDE Respite Services can be provided, up to an annual cap, so caregivers may take a break when they need to. Support comes from local in-home respite providers, adult day centers and nursing homes. 

Coordination & Support

Get connected to community-based services like meals and transportation. Care teams will also work together to coordinate clinical and support services. 

24/7 Access

Care navigators help you get care and 24/7 access to a care team member or helpline to ask questions or get support. 

How to Access GUIDE Services & Supports

To be identified as a potentially eligible participant, complete and submit the GUIDE Consent & Eligibility Verification Form below.

*Participants must be enrolled in Original Medicare Parts A & B and meet other eligibility requirements. Participants are always free to see any doctor or hospital that accepts Medicare. 

GUIDE Consent & Eligibility Verification Form

Print Consent form

"*" indicates required fields

This field is for validation purposes and should be left unchanged.
Name of person/caregiver providing consent*
Patient Name*
Actual name as it appears on Medicare Card.
MM slash DD slash YYYY
Required to check diagnosis.
Only required to find MBI if not available.
Usually found on 'Problem List' of medical history, i.e.: F03.90.
Patient Address*
If patient lives in Assisted Living, Independent Living, or Memory Care, provide last home address in community before moving.
Does beneficiary/caregiver consent to receive communications via email?*
Does beneficiary/caregiver consent to receive communications via text?*
Terms and Conditions*

Name of person obtaining consent: Angel Baginske, Director, 574-232-4121, angel@alzni.org, Partner Organization: Alzheimer's and Dementia Services of Northern Indiana

online Consent form
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