This is the Whole Care Network. Music Helping you tell your story one podcast at a time. Content presented in the following podcast is for information purposes only. Views and opinions expressed in this podcast are solely those of the host and guest and may not represent the views and opinions of the Whole Care Network. Always consult with your physician for any medical advice and always consult with your attorney for any legal advice. And thank you for listening to the Whole Care Network. Music In this episode, Nancy and I are talking with Amy Ives of Emory's Integrated Memory Care about the new Medicare program guide. We're going to be learning what it is and how to know if you can leverage it. We're sharing three tips. Welcome. We are Sue Ryan and Nancy Treister. This podcast brings our years of experience in a variety of family caregiving roles to prepare you to navigate your caregiving journey. We're sharing our personal experiences, not medical advice. And because it's our passion to support you on your journey, we believe no topic is on limits. Let's get started. Music Welcome, Amy. We are so excited to have you. This is an awesome opportunity to talk about the U.S. Medicare Guide program. And if you're listening on the day this is published, there's a big, a lot of big announcements today, which is July 1, 2025. So we're excited to give you an overview so you can understand how you might participate in the Guide program. But first, let me introduce you to Amy. I'm going to read you her bio. Amy I's is a gerontological nurse practitioner who is a trusted expert in geriatrics, demonstrating a deep understanding of the unique healthcare needs of the aging population. Throughout her career, Amy has played a pivotal role in building care models. That's important to the Guide program and developing teams that yield superior outcomes. In addition to her clinical work, she is a member of the team of at Emory's Integrated Memory Care, which is a nurse practitioner-led primary care practice for patients living with dementia. She's also the program lead for the Medicare Guide program at Emory Healthcare. Sounds like we have the right person to answer that. Absolutely. So, Amy, let's start with, tell our listeners what Guide is. Thanks for having me. I'd love to share all the innovation that's happening in the brutal geriatrics. Guide stands for Guiding and Improved Dementia Experience. It is a U.S. Medicare pilot program that aims to provide better support and resources for persons living with dementia and their caregivers. Which is awesome. And you heard Amy say it's a pilot program. You're going to find out how to join it. But please, let's all support it because we need to prove that this pilot program, which focuses on helping dementia caregivers, actually works so that this can become a standard part of Medicare. And can also be expanded globally. Yes. It would be ideal for the U.S. to prove it's worth so that we can help other countries. Absolutely. Because they're watching and they're aware of it. And this is a great thing. Good point. Thanks for those points. I think it's really important to highlight that. This is a groundbreaking program that is being offered around the country. So definitely we want to show up and show out as people tend to say sometimes. The guide program offers like one-on-one support and coaching by dementia profession providers. Care navigation through an often difficult and chaotic healthcare system. Yes. Education and training and resources to caregivers, which is much needed. Amazing. Lots of tools and resources that we can share along the way. And also respite, which we'll talk about a little bit later, but that's respite offering for Medicare beneficiaries is unprecedented. It's never been done before. And it's really, really exciting. As of today, July 1st, there were there are approximately 390 programs across the country that have been vetted by Medicare to provide this program. And so it is really, really going to have an impact for persons living with dementia. Which is huge because it's fully funded by Medicare. I mean, this is just, this is amazing. And this is the first time and this is so incredibly important and valuable. And this is why Nancy and I prioritize this as something that really stands out because it's the first time Medicare is recognizing the caregiver and conservatively in the United States. There are over 12 million caregivers who are providing millions of hours of unpaid support. And these are the family caregivers specifically for people living with dementia. Specifically. Yeah, not even any of them. Yeah. Yeah. So the need is huge. Having it being recognized and doing such a responsible job of the program is just is incredible. And so this takes us to our first tip, which is if this sounds like something that you would be interested in. How do you find out if you're eligible? That's a great question. To be eligible for the guide program. Patients need to have Medicare, both Medicare and B Medicare. Traditional Medicare needs to be the primary payer since this is a Medicare pilot program. So unfortunately at this time patients enroll or beneficiaries enrolled in Medicare vantage aren't eligible. We may see that change down the road. Patients cannot be enrolled in hospice and cannot live in a long-term care skilled nursing facility. And so those are really. But you can be like an assisted living. Absolutely. Absolutely. Good distinction. But that is a good distinction. Although being those terms get really blurred. I know. That's why we bring it up. Yeah. Within guide. So you're eligible. What do you get? Like what's that a benefit? It provides a comprehensive assessment by a dementia proficient provider. Medicare has done a really good job at requiring providers that are touching patients and caregivers to actually be the experts in their field. Wow. Right. Yeah. That's so important. The amount of vetting that we had to go through for that was for those of us that have been working forever is just. Finally somebody's listening to us. Yeah, it's encouraging actually. It is very. There's an entire interdisciplinary team. That's really important too. It's not just me out in the world providing support and care, which I always love to do. But there's an entire team of people. And so we can really hit different aspects of people's lives and caregiving. There is a care navigator, a dedicated care navigator for each beneficiary and caregiver group. That is huge. I mean, there's someone speaking. There's someone specific. Right. This program actually also requires that we're proactive and so the care navigator is your person that's going to help you steer, you know, or help you paddle down the river or maybe up the river. I feel that way. Yeah. We often feel that we're patling up the river. Yes. But we're not, you know, within this program, Medicare really realizes that caregivers are overwhelmed and extremely busy. And sometimes you don't have time to stop and call and ask the questions. So I do love that they expect programs and participants to be very proactive and reaching out, offering resources, really being in tune to each individual, you know, Diane's needs. Well, and having someplace and someone to call is huge. Yeah. Yeah. It is really nice. And so that care navigator is just really going to be the one that's going to sort of quarterback within the team. Okay. Although each of these participation participating programs are really the quarterback for your overall care of our patients. Okay. There is a one-time home assessment that's really just done sort of right after the time of enrollment into the guide program. And the intent of that is sending somebody with a trained eye in to get a feel of what does day to day look like. Okay. And that's what I'm saying to caregivers. So is there, are there tweaks along the way? Anything that we can recommend that would help patients maintain their independence that would help make things easier for the caregiver? Yeah. You know, whether it's set up or, you know, live in directing people in a way. And I tell you, but in doing this the last year, sometimes it's just moving the light light from the hallway into the bathroom. Wow. Yeah. The other thing that's back favorite is that I've done for many patients is putting a picture of a commode on the bathroom door. Now, seriously, there are so many people that would never have known about that or thought you wouldn't. You wouldn't. It seems too simple. Yeah. It's the little things. It's the little things, but they're huge. They're huge. Yeah. I've always said this that caring for patients with dementia and their families, it's the little things that make the difference. It's the little bitty tweaks. And they're so little that they really are game changer. But the impacts are out are just overwhelming at times. Yeah. So that's the intent of that, which I just think is really, really neat and it's been extremely helpful for a lot of caregivers that made a big difference. You know, if you can make two mornings a week easier, right? We'll take it. Everybody's like, oh, we'll take it. Yeah. All of our listeners are going, please. I know. I mean, maybe five days of worry. Five days of worry. Also guide, requires a participating programs provide dedicated. It's ongoing training and support. This is an eight year pilot. So, you know, this is not committed. We're going to teach you and we'll check on you. It's really, really providing resources and so that shoulder to shoulder support. Now, when you have the pilot program, you don't have to be able to commit to it for eight years because you may not have that journey. So clarify that a little bit. Yeah, that is a good Medicare has dedicated to fund this program for the next eight years, which is important to be able to measure the interventions that we're doing and what those outcomes are. There's actually no commitment required for guidance voluntary is really just an additional Medicare benefit. There's no cost to patients. There's no contract. You can voluntarily in and out and stay as long as you want. Stay as long as you want. Okay. That's great. That's a great clarification. Okay. Yeah. They also require that we provide 24 seven. So there's a lot of programs or a lot of parts of programs that have been providing, you know, pieces of this program along the way, but not everybody was available 24 seven. We probably all have the Alzheimer's 24 seven hotline number in our phone still probably right. Oh, yes. But that's not always the tailored help that you need. Right. It's not personalized to your fantastic to the care that you've right. It's not personalized to the care that you're getting. So they do require all of the participating programs for about 24 seven support, which is huge because it's so interesting. Things always happen at three o'clock in the morning. They happen in the middle of the night. It's like this. It doesn't necessarily happen at 930 in the morning or two in the afternoon. We talked about the care coordination. This is a program that really aims at being the quarterback being the overseer the collector of all the things and medical care. Medicare very actively expects these programs to coordinate with the existing medical team that patients have, making sure that hospital transfers and discharges are changes between care levels are very smooth and free from chaos or disaster. Let's talk about the respite benefit. Respite is where as a caregiver, you can step away and have somebody come in and actually take care of your left one. Sounds wonderful. People that enroll within guide are eligible for up to $2,500 a year in respite. That's one paid respite here to come in. So patients in an earlier stage and are still fairly independent may not need that, you know, that level of oversight. Sure. The guide requires participating programs to provide at least in home respite. So sending a paid caregiver in so people can get away. Taking that massive. Yeah, massive. No, it's huge. But those benefits can also programs can participate in programs can also use that respite benefit for adult day programs and in patient. Those are available. So if I if I like hearing all this and all this sounds like something that would benefit me, then let's talk about tip 2, which is how do I find a guide program near me. You just said there were 390 of them. So that sounds like a lot, but maybe not. We're a big country. The good thing is, is that they're they're nicely scattered across the country. You know, it doesn't seem to be too heavily populated in certain areas. Medicare designates the service area for each participating program. Right. And that's just to ensure that if you're going to provide this level of care, you're going to provide this little care. So they don't want people to sort of over promise. And so each participating program had to designate the geographic area that they could provide services in. So that's important to note. Yes. Medicare has a website for guide. It's a really long Medicare name. Goverment website. But I usually just tell people to Google Medicare plus guide plus dementia and it pops up pretty easily. That's awesome. And then we'll of course, as always put the link in the show notes. So they don't have to have to. Right. You know, I tell you, I got a call from a caregiver a few weeks ago. His wife was away at her adult day program and he was just one of those boardings. And he just hit the end of his rope and he called and he said, Amy, I'm literally sitting outside in the rain. I just kidnaped his today. So we were able to help him, you know, set up a respite right around the corner. So he just went great. But I think every caregiver has that day. Oh, yes. Days or periods of time and just been amazing to be able to provide that level of help that people don't have to come out of. A pocket board. It's just, it's just incredible. So I'm very, very excited about that part. For people who already have a medical care team, it would be helpful to find out, you know, how we integrate with them. And that happens to be tip three. So how do we integrate the guide program in with our existing medical team? Right. That's a great question. It is. This really should be a nice add on our augmenting. Each program is going to vary a little bit, right? And the depth of the level and management of what they're providing. But because the requirement of documented care coordination, it should be something that would easily just fit on. Okay. To somebody's existing medical team. So there wouldn't be any conflict. Okay. I wouldn't think too easily. But you know, that does bring up a good plate. You want to ask the right questions, right? How do you know? I've just said that every program is going to do this a little differently. Yeah. I know what's going to be good for you. So I did bring a list of questions. Good. Good. I think the first question is, can I keep existing medical teams? That okay with you guys? Not that it's okay. Would that provide any conflict? I think it's a better way probably to ask that. And how are you going to coordinate with my existing specialist and medical medical providers? What's expected for me? So what's the frequency look like to have to come in? Is this through telehealth? This phone calls? This is phone triage? How often do we have to do this exactly so you know if this is going to be the right bet, right? Right. And you did say, I asked you this and I think you told me. So even though there's 390, which sometimes sounds like a lot and sometimes doesn't when you think about the size of the country, there can be, if you're in some geographies and more than one. There can be. So you do want to understand what these questions are. And because of like what you just said, some are going to provide more service than others. So you need to understand which one fits best with what you're looking for. Right. Right. Particularly in a, you know, unfortunately in larger metropolitan areas, there are likely to be multiple guys. There are likely to be multiple programs. But also in Georgia, there's going to be some rural overlap too, which is really nice. That is nice because they usually don't get that. They usually don't get that. But you know, every, every geographic area is going to be a little different. Okay. What exactly is available to us? Right. So what are the classes and how are those offered? Are they in person? Are they via zoom? Are they self directed? What are the support groups? And I think like what kind of support groups is also really important. You know, I think that this particularly in caregiving for patients with dementia, having that circle of support that really helps you. Yes. Care for your loved one with dementia. And I always explain it by saying, you know, if I'm a 30 year old daughter taking care of her mother with an early onset Alzheimer's, maybe that Tuesday at 10am group of spouses taking care of their husbands, is it maybe going to be the best fit for me? You know, so just making sure and also voicing, you know, straight up for it is important. That's good. Helpful. Yeah. There are ongoing assessments, right? So we also are patients and caregivers have a little bit of responsibility in this program as well. There's ongoing assessments that will measure caregiver stress and burden. Quality of life for persons living with dementia, staging of dementia along the way. Are there any health related social needs that are impacting care in any way so that we can develop resources? And so those assessments are going to have to be at least annually and sometimes more if we're doing a reassessment. That's reasonable though. Yeah. There is. They're, they're not in depth in number of questions, but they're asking tough questions. And so it's really, really important for caregivers to answer this honestly. You really and truly this is not the time to sugar coat it. We need to show Medicare and the rest of the world. This is a game changing program, right? Dementia care will be changed indefinitely by the findings from this program. So we need to really show how hard this is or how hard it can be because your stress is managed. Does it mean that you're not having stress? Right. That's huge. Just because you're managing it doesn't mean you don't have it. Right. Yeah, absolutely. And this is a pilot program. It's, it's absolutely, as you said in the beginning, it's groundbreaking. It's a Medicare pilot program. And it's for those of us who are caregivers, I mean, huge opportunity. So when you say tell it like it is, I mean, this is our opportunity to tell it like it is. And to be really honest about it, because it is a big deal and it is, it's the longest struggle. And for us, training and respite really do matter. They really move the needle. And when we think about the impact that we can have in our lives, and then as this works in the lives of more people here in the United States, and then also around the world, this is huge. So it's a great opportunity. I'm so thrilled that you're sharing all this information with us. Yeah, I mean, it is truly at the time where I think we want to make sure as many people as possible know about this program. But there will be people who are in the Atlanta area, which is what Emory serves. So why don't you tell us a little bit about Emory IMC in case people are interested specifically about your program. The integrated memory care clinic at Emory is a clinic really led by nurse practitioners. We're all dementia specialist and geriatric specialist providing primary care for patients with dementia. So we have, we try to bring everything into one umbrella. So we have Jerry Syke, we've got licensed social workers, our ins on our team. It eliminates some of that Dr. Hopper up and down the road business. It was hard enough to get in the car one day. Oh yeah, definitely harder to get in the car three days. We are clinic is located part of the every clinic system. We're at Nortuary Hills and Broward Cliff, right next to the park. But we also have a community arm of our of our clinic where the nurse practitioners are making house calls to various communities around the large area. So that's just been a really fun thing to participate in and we'd love to talk to you guys some questions. Yes, awesome. You know, this has been fantastic. I know Sue and I both felt like this was really important topic and very important. So much light to it. Thank you. Thank you. Thank you so much. Thank you. Thank you. Thank you. I just cannot stress enough. There's really no downside for people joining the guide program or enrolling in it. The more we put into a program like this, the more we're going to get out of it. Well Nancy and I would both have been right at the top of the list of people volunteering. When if this had started a few years ago so hopefully this can be a method of supporting other people being able to take advantage of something that that they're going to get so much benefit from. Yeah. All right, well let's summarize. Okay. Today, Sue and I talked with Amy Ims about the US Medicare guide program and really all that it can do to help dementia family caregivers. We talked about three tips. First, understand your eligibility and how to understand your eligibility. Second, how to find a guide program near you. And third, how would the guide program be incorporated into your existing medical team. Now, if you've been a participant guide already, or you know something about the guide program, feel free to put any tips you might have on our Facebook page or our Instagram page. The links are in the show notes. We'll also make sure the links to how to find the guide program are in the show notes as well. Now remember also any podcast. Just look at the number of the podcast. And if you go to the caregiver journey.org. You look at our blog, the blog portion of our site, there's a matching blog. So we've effectively taken notes for you so you don't have to take notes and remember everything we said on this podcast. Just go print off the blog. If you like this podcast, please share it with anyone you think it might help. Please follow us or subscribe to it. We really, really appreciate it. And as we always say, we're all on this journey together.
