Bringing 24/7 virtual nursing support and respite care to families at no cost through Medicare’s groundbreaking dementia care initiative
Supporting Families Through Every Step of the Dementia Journey
At A Place At Home, we understand that caring for a loved one with dementia can feel overwhelming, isolating, and exhausting. That’s why we’re proud to announce our strategic partnership with PocketRN, a leading virtual nursing platform that’s revolutionizing dementia care through the Centers for Medicare & Medicaid Services (CMS) GUIDE program.
This partnership marks a significant milestone in our commitment to providing comprehensive, compassionate care that keeps families together, ensuring no one faces the challenges of dementia alone.
What Makes This Partnership Groundbreaking
The Power of the CMS GUIDE Model
The Guiding an Improved Dementia Experience (GUIDE) Model is a Centers for Medicare & Medicaid (CMS)-backed initiative that began on July 1, 2024, and will operate for eight years. This groundbreaking initiative is designed to enhance the quality of life for individuals with dementia and alleviate the burden on their caregivers.
As one of approximately 400 participants nationwide, PocketRN brings its innovative Nurse for Life approach to families dealing with dementia, offering comprehensive support at no cost to eligible Medicare beneficiaries.
Comprehensive Care That Goes Beyond Traditional Services
Through our partnership, families gain access to a comprehensive suite of dementia care services that address both immediate needs and long-term support:
24/7 Virtual Nursing Access PocketRN connects families directly with experienced nurses through a secure, user-friendly interface, providing clinical guidance, emotional support, and help answering questions that arise during dementia care. Once matched with a nurse, they remain a consistent presence—following your family’s care journey and providing personalized support through every step.
Personalized In-Home Respite Care Families who qualify for the respite benefit receive up to 72 hours of in-home care per year, delivered by our trained A Place At Home caregivers. This vital service provides family caregivers with the time they need to rest, recharge, and attend to their own well-being.
Ongoing Care Coordination The program includes comprehensive care coordination with existing doctors, specialists, and medical equipment suppliers, ensuring seamless communication across all aspects of your loved one’s care.
Addressing the Critical Need for Dementia Care Support
The Reality of Family Caregiving
According to a recent AARP study, over 84% of family caregivers report that caregiving had a moderate or high impact on the stress they feel daily. Dementia care presents unique challenges that can lead to caregiver burnout, social isolation, and financial strain.
The anticipated outcomes of the GUIDE Model include increased caregiver empowerment and a reduction in Medicare and Medicaid expenditures—primarily achieved by preventing or delaying the need for long-term nursing home stays.
Breaking Down Barriers to Quality Care
Traditional dementia care options have often been fragmented, expensive, and difficult to access. Our partnership with PocketRN through the GUIDE program removes these barriers by providing:
- Zero cost to eligible Medicare beneficiaries
- Immediate virtual access to dementia-trained nurses
- Consistent care relationships that build trust over time
- Flexible support available when and where families need it most
How the Partnership Works
Seamless Integration of Services
Our collaboration creates a seamless care experience that combines the best of both organizations:
- Initial Assessment: PocketRN conducts comprehensive virtual assessments in alignment with CMS requirements
- Home Safety Evaluation: Our A Place At Home team performs thorough home safety assessments
- Ongoing Support: Families receive continuous virtual nursing support and regular in-home respite care
- Care Coordination: Both teams work together to ensure all aspects of care are coordinated and optimized
Technology That Connects, Not Complicates
Families can video chat with their nurse anytime, anywhere—24/7 virtual access makes it easy to get support when it’s needed most. The platform is designed to be user-friendly and accessible through smartphones, tablets, or computers.
The Impact on Families and Communities
Real Support for Real Challenges
As Jennifer Axelrod, National Accounts and Growth Strategist at A Place At Home, explains: “Caregiving for a loved one, especially one with dementia, can be overwhelming physically, emotionally, and financially. This partnership gives families a lifeline. By combining Medicare-covered respite hours with 24/7 access to trained nurses, we’re not only expanding care, but we’re also helping caregivers breathe, reset, and know they’re not alone.”
Broader Healthcare Benefits
The program aims to bring about a secondary reduction in hospital, emergency department, and post-acute care utilization, creating positive ripple effects throughout the healthcare system while keeping families together at home.
Looking Ahead: The Future of Dementia Care
Expanding Access to Quality Care
PocketRN will utilize its national network of expert nurses to dramatically expand access to care for dementia patients and their families who may otherwise go without it. This eight-year initiative represents a fundamental shift toward more accessible, equitable, and effective dementia care.
Getting Started: How Families Can Access These Services
Eligibility and Enrollment
To qualify for the GUIDE program benefits:
- Has dementia (a diagnosis can be provided)
- Is enrolled in Traditional Medicare Parts A & B
- Lives at home or in independent/assisted living
- Is NOT currently in hospice or a skilled nursing care resident (short-term stays are OK)
To qualify for RESPITE benefits:
- Has moderate to severe dementia
- Has a family member or unpaid caregiver (does not need to live with the individual with dementia)
Contact Information
Families interested in learning more about our PocketRN partnership can:
- Call PocketRN directly at (872) 233-4490
- Contact your local A Place At Home to discuss how our services integrate with the GUIDE program benefits
Our Commitment to Comprehensive Care
This partnership with PocketRN reinforces our fundamental belief that every family deserves access to high-quality, compassionate care for individuals with dementia. By combining our expertise in in-home care with PocketRN’s innovative virtual nursing platform, we’re creating a new standard of care that truly puts families first.
As PocketRN CEO Jenna Morgenstern-Gaines states: “With PocketRN, patients and families get unwavering support from a dedicated, trusted nurse as they navigate the complexities of managing dementia at NO cost to them.”
Ready to learn more about how our partnership with PocketRN can support your family? Find your local A Place At Home location using our website, or visit aplaceathome.com/pocketrn to discover how the GUIDE program can provide the comprehensive dementia care support you need, when you need it most.