Medicare GUIDE Dementia Respite Care in Washington
Does Medicare Cover In-Home Dementia Care?
What Washington Families Need to Know About the GUIDE Program
In-home dementia respite care may be available at no cost for eligible families in King, Snohomish, and Pierce Counties, Washington.
Caring for a family member with Alzheimer’s disease or another form of dementia is one of the hardest things a person can do. Families are often managing around-the-clock supervision, safety concerns, behavior changes, and caregiver burnout — with little or no time to rest.
Medicare’s GUIDE program — Guiding an Improved Dementia Experience — was created specifically for families in this situation. Through our partnership with PocketRN, a CMS-approved GUIDE dementia care provider, eligible families in the Puget Sound area may be able to access nurse support, caregiver education, care coordination, and in-home respite care at no cost through Medicare.
Acti-Kare Puget Sound serves families across King, Snohomish, and Pierce Counties. When a family is enrolled in GUIDE through PocketRN and approved for in-home respite care, Acti-Kare can provide the in-home caregiving support.
Download our family handout to learn what GUIDE respite care may include, who may qualify, and how Acti-Kare may be able to help.
Download The No-Cost Dementia Respite Care Guide
What is Medicare’s GUIDE program?
GUIDE stands for Guiding an Improved Dementia Experience. It is a care model developed by the CMS Innovation Center to provide comprehensive support for people living with dementia and the family caregivers who help them remain at home. The GUIDE program is one of the first Medicare models to directly support unpaid family caregivers.
The program is administered through approved GUIDE program providers — not directly through home care agencies. Acti-Kare partners with PocketRN, a CMS-approved GUIDE provider, to support eligible families in our service area. PocketRN provides clinical coordination, nurse oversight, caregiver education, and enrollment. Acti-Kare provides the in-home caregiving support for families approved for respite care.
What is GUIDE respite care?
GUIDE respite care is short-term in-home care that gives family caregivers a scheduled break while their loved one receives support in a familiar, safe setting.
For qualifying families, the GUIDE program may include up to 72 hours of in-home respite care per year, used in 4-hour increments. Unused hours reset on July 1 of each year and do not carry over.
Respite care is practical support designed to prevent burnout, reduce caregiver isolation, and help families sustain home-based care longer.
An Acti-Kare caregiver may help with:
- Companionship and supervision
- Personal care support (bathing, dressing, grooming, toileting)
- Meal preparation, hydration reminders, and routine support
- Dementia-informed redirection and routine support
- Fall-risk and wandering-awareness support
- Light housekeeping related to care
- Caregiver relief so family members can rest, work, attend appointments, or run errands
About our GUIDE program partner: PocketRN
PocketRN is a CMS-approved GUIDE dementia care provider and Acti-Kare’s clinical partner for this program. PocketRN’s dementia-trained nurses lead the enrollment, assessment, and care coordination functions of the GUIDE program.
GUIDE care through PocketRN may include:
- A dedicated dementia-trained nurse for regular phone and video check-ins
- Care coordination with existing doctors, specialists, and medical equipment suppliers
- Medication review
- Family support, education, and 1:1 coaching
- Management of other chronic conditions such as diabetes, heart disease, or cancer
- Referrals to community resources
PocketRN determines eligibility, handles enrollment, and manages all CMS requirements. Acti-Kare’s role is the in-home caregiving support for families approved for respite hours.
Who may qualify for GUIDE?
A person may be eligible for GUIDE if they:
- Have an Alzheimer’s disease or other dementia diagnosis
- Are enrolled in Traditional Medicare Parts A and B
- Are not enrolled in Medicare Advantage
- Are not currently on hospice
- Are not living in a skilled nursing facility (short-term stays may be acceptable)
For in-home respite care specifically, the person typically must have moderate to severe dementia and a family or unpaid caregiver who is actively involved in their care.
Important: VA patients, dually eligible Medicaid patients, and individuals in memory care settings may also qualify. Eligibility is reviewed individually by PocketRN.
Eligibility, approval, respite hours, and scheduling rules are determined by PocketRN as the approved GUIDE program provider. Acti-Kare does not determine Medicare eligibility or GUIDE enrollment.
Who counts as a family or unpaid caregiver?
The GUIDE respite benefit is designed for family caregivers. You may qualify as a family or unpaid caregiver if you are a relative or unpaid non-relative who helps your loved one with any of the following, even occasionally:
- Meal preparation or eating
- Bathing or dressing
- Toileting
- Transportation
- Managing finances
You do not need to live with your loved one. You do not need to be the Power of Attorney. Family members who receive payment through Medicaid or VA programs still count as family caregivers for GUIDE purposes.
Paid home care agency caregivers who are not relatives do not qualify as family or unpaid caregivers for purposes of this benefit.
What if my family member doesn’t have a formal diagnosis yet?
A formal dementia diagnosis is required for GUIDE enrollment, but you do not need one before calling Acti-Kare. If your family member shows signs of memory loss or cognitive decline — even without a confirmed diagnosis — it is worth a conversation.
PocketRN’s clinical team can complete a comprehensive assessment and, if appropriate, help facilitate a cognitive screening. Common signs that may indicate dementia include memory loss, difficulty with daily tasks, sundowning behavior, or medications such as donepezil (Aricept) or memantine (Namenda) being prescribed.
How to get started
1. Call Acti-Kare
We’ll talk through your loved one’s situation and whether GUIDE respite care may be worth exploring. Contact us at 425-419-4452. There is no obligation.
2. We connect you with PocketRN
With your permission, we introduce you to PocketRN, our approved GUIDE program provider partner. PocketRN’s team completes a welcome call, gathers Medicare information, and begins the eligibility and enrollment process.
3. PocketRN reviews eligibility and enrolls your family
PocketRN handles all CMS documentation, assessments, and enrollment. The review process typically takes 30 days when a diagnosis is already on file, or 45 or more days if a cognitive assessment is needed first.
4. Respite care begins
If your family is approved for respite, Acti-Kare may provide scheduled in-home respite care under the program. You will not be billed for authorized GUIDE respite hours.
Important details to know
- GUIDE respite care is not unlimited home care. It is a defined Medicare program with eligibility requirements, enrollment steps, and scheduling rules.
- Respite care is used in 4-hour increments. Visits of fewer than 4 hours are not permitted under the program.
- If you send the caregiver home early, the originally scheduled hours are still deducted from your annual allotment.
- Unused hours reset on July 1 each year and do not carry over.
- The annual hour amount may vary slightly from year to year as determined by Medicare.
If your family needs more support than GUIDE respite provides, Acti-Kare can talk with you about private-pay home care, dementia care, personal care, companionship, transportation, and additional respite care beyond the GUIDE program.
Download the handout
Our handout gives families and care team members a clear, practical overview of Medicare GUIDE dementia respite care: who may qualify, what respite care includes, and how Acti-Kare and PocketRN work together to support eligible families.
Frequently asked questions
What is Medicare’s GUIDE program?
GUIDE stands for Guiding an Improved Dementia Experience. It is a care model developed by the CMS Innovation Center to support people living with dementia and their family caregivers. The program may include care coordination, nurse support, caregiver education, and in-home respite care at no cost to eligible families. Acti-Kare Puget Sound partners with PocketRN, a CMS-approved GUIDE provider, to serve eligible families in King, Snohomish, and Pierce Counties in Washington State.
Who may qualify for GUIDE dementia respite care?
A person may qualify if they have an Alzheimer’s or dementia diagnosis, are enrolled in Traditional Medicare Parts A and B, are not enrolled in Medicare Advantage, are not on hospice, and are not residing in a skilled nursing facility. Short-term skilled nursing stays may be acceptable. For in-home respite care, moderate to severe dementia and an involved family or unpaid caregiver are typically required. VA patients, dually eligible Medicaid patients, and individuals in memory care settings may also qualify. Eligibility is determined by PocketRN, not by Acti-Kare.
How many respite hours may be available through GUIDE?
Qualifying families may receive up to 72 hours of in-home respite care per year through the GUIDE program. Respite is used in 4-hour increments, and unused hours reset on July 1 each year. The annual amount may vary slightly from year to year as determined by Medicare.
Does my family member need a formal dementia diagnosis to get started?
A formal diagnosis is required for GUIDE enrollment, but you do not need one before reaching out. If your family member shows signs of memory loss or cognitive decline, call Acti-Kare and we can connect you with PocketRN. PocketRN’s clinical team can complete an assessment and, if appropriate, facilitate a cognitive screening.
Who counts as a family or unpaid caregiver for GUIDE?
A relative or unpaid non-relative who helps their loved one with any caregiving task — including meal prep, bathing, dressing, toileting, transportation, or managing finances — qualifies as a family or unpaid caregiver, even if they only help occasionally. The caregiver does not need to live with the person with dementia and does not need to be the Power of Attorney. Family members paid through Medicaid or the VA also qualify.
Does Acti-Kare determine GUIDE eligibility?
No. Eligibility, enrollment, and respite hour approvals are determined by PocketRN as the approved GUIDE program provider. Acti-Kare helps connect families to PocketRN and, if a family is approved for in-home respite care, provides the caregiving support portion of the program.
Can GUIDE respite care be provided at home?
Yes. In-home respite care is one of the respite options available through the GUIDE program for qualifying families. Acti-Kare provides home-based caregiving support for eligible families in King, Snohomish, and Pierce Counties in Washington State.
What can an Acti-Kare caregiver help with during a GUIDE respite visit?
During a GUIDE respite visit, an Acti-Kare caregiver may provide companionship and supervision, personal care support, meal preparation and routine assistance, dementia-informed redirection, fall-risk and wandering-awareness support, and light housekeeping related to care. The goal is to allow the family caregiver to rest, work, attend appointments, or step away knowing their loved one is supported.
Is GUIDE respite care really at no cost?
The GUIDE respite benefit is covered by Medicare at no cost to eligible families. There are no copays. Families approved through PocketRN will not be billed for authorized GUIDE respite hours provided by Acti-Kare.
What if we need more care than the 72 GUIDE hours provide?
Acti-Kare also offers private-pay home care services including dementia care, personal care, companionship, transportation, and additional respite care beyond what the GUIDE program provides. We can talk through your family’s full situation when you call.
About Acti-Kare Puget Sound
Acti-Kare Puget Sound is a local, family-run, VA-credentialed in-home care agency serving families across King, Snohomish, and Pierce Counties. We have been supporting families in the Puget Sound region for over ten years, providing dementia care, personal care, companion care, respite care, and transportation services.
Acti-Kare Puget Sound is not a Medicare GUIDE participant and does not determine GUIDE eligibility or enrollment. We partner with PocketRN, a CMS-approved GUIDE dementia care provider, to support eligible in-home respite care for families in King, Snohomish, and Pierce Counties, Washington.
