A look at caregivers for community-living persons with dementia: Implications for the GUIDE model

INTRODUCTION: Medicare's new Guiding an Improved Dementia Experience (GUIDE) model funds integrated dementia care and related caregiver supports for community-living persons with dementia (PwD). Caregiver strain is a factor in provider payment and performance. METHODS: We examined national survey data on community-living PwD and their caregivers to identify which caregivers would receive support under GUIDE and characterize caregiver strain and use of supportive services. RESULTS: Half of GUIDE-eligible PwD received care from multiple caregivers and high strain was common even among caregivers considered "low-complexity" under GUIDE. Use of role-related training, respite care, and support groups were low (11%, 18%, and 4%, respectively) and did not vary with caregiver strain. DISCUSSION: Caregiver identification and assessment standards under GUIDE may overlook a significant number of caregivers. To maximize impact, innovative models like GUIDE should align caregiver engagement and services with the unique realities of care networks for PwD.