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DHI-GUIDE Dementia Program

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Program Enrollment855-335-4677delawarehospice.orgDelaware Hospice, Inc. is participating in the “Guiding an Improved Dementia Experience” (GUIDE)program by the Centers for Medicaid and Medicare Services (CMS), offering specialized services fordementia care and support for caregivers (a relative or unpaid non-relative who helps with activities ofdaily living). Our GUIDE-approved Dementia Care Program offers comprehensive support, ensuringpatients and caregivers receive the care and resources necessary to navigate the challenges of dementia.Our Dementia Care Program: Support for Living with DementiaImprove Quality of Life for people livingwith dementia by providing comprehensivesupport by addressing their behavioralhealth and functional needsEnhance Support for caregivers of peopleliving with dementia through caregiver skillstraining and referrals to community-basedsocial services and supportsSupport Independence by helping peoplewith dementia remain safe in any settingPrevent or delay long-term nursinghome care for as long as appropriateCoordination of care for dementia and co-occurring conditions and improvingtransitions between community, hospital,and post-acute settingsRespite Services can be provided, up toan annual cap so caregivers may take abreak when they need to* *Qualified beneficiaries of Dementia Respite Services will receive support from local partners: in-home respite providers, adult day centers and nursing homes.Get the support you need. Call us today! 855-335-4677 Have a diagnosis of dementia, as confirmedby clinician attestationDelaware Hospice is accredited by the JointCommission and provides care throughout Delawareand southern Chester and Delaware Counties inPennsylvania. It is state licensed, Medicare/Medicaidcertified. As a recipient of Federal financialassistance, Delaware Hospice, Inc. does not exclude,deny benefits to, or otherwise discriminate againstany person on the basis of race, color, nationalorigin, disability, sex, or age in admission to,participation in, or receipt of the services andbenefits under any of its programs and activitieswhether carried out by Delaware Hospice directly orthrough a contractor or any other entity with whichDelaware Hospice arranges to carry out its programsand activities. | Tax ID# 51-0258883©2024 Delaware Hospice, Inc. Not reside in a long-term nursing home Be enrolled in Medicare Parts A and B (notenrolled in Medicare Advantage, includingSpecial Needs Plans and PACE) Have Medicare as their primary payer Not be enrolled in Medicare hospice benefitTo be eligible for the GUIDE-approvedDementia Care Program, beneficiaries must:If you do not qualify for this program, alternativesupport may be available through anotherDelaware Hospice, Inc. program. Enrollment begins with an initial assessment,where a team member will meet with the patientand caregiver to complete questionnaires.Accurate and thoughtful responses are crucial toensure proper benefit assignment.Qualified beneficiaries will be placed into one offive tiers based on disease stage and caregiverstatus by CMS. Each tier reflects care needs andintensity, with benefits increasing by tier to matchthe level of support required.Dementia Care Goals

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Help & Support Received: Anne contacted Delaware Hospice, Inc. about theDementia Care Program; they were able to work with Mildred’s physician toconfirm eligibility for program services. Mildred and Anne began collaborating withan interdisciplinary care team through the Delaware Hospice Dementia CareProgram. Our Care Navigators connected her with transportation services, making it easier for her to attend appointments. Anne received caregiver training through Delaware Hospice,helping her manage Mildred’s symptoms and cope with her own stress. Additionally, Mildred qualified forand benefited from Dementia Respite Services, allowing Anne to take much-needed breaks from hercaregiving responsibilities. Now, Mildred and Anne are enjoying the time spent together and with family.Patient & Family Caregiver: Mildred is an 86-year-old woman living alone withmoderate dementia. She has regularappointments with her primary caredoctor, dentist, and optometrist, and getsher medications from a local pharmacist.Her caregiver, Anne, is her 35-year-oldgranddaughter who visits daily to help with housekeeping and personal caretasks. Anne is a mom with a full-time job.Initial Challenges: Mildred’s dementia symptoms weresteadily worsening, and her primary care doctor was notequipped to provide the specialized care she needed. Asher condition progressed, Mildred found it increasinglydifficult to manage her medications and attendappointments on her own. Meanwhile, Anne, who hadbeen her primary caregiver, was feeling overwhelmed andexhausted by the demands of caregiving. Despite wantingto find a suitable nursing home for Mildred, the high costsmade it an unfeasible option.Example of how our Dementia Care Program can helpCare CoordinationThe care plan will identify thepatient’s primary care provider andspecialists and outline the carecoordination services needed tohelp manage the dementia and co-occurring conditions.Caregiver ServicesDelaware Palliative will assess andaddress caregiver needs and include thecaregiver as part of the care team asappropriate. Caregiver services willinclude ongoing monitoring and supportvia 24/7 access to a support line.The interdisciplinary care team delivers services by creating and maintaining a person-centered careplan, which includes details on patient goals, strengths, and needs; comprehensive assessment results;and recommendations for service providers and community-based social services/supports.Care Delivery ApproachAdditional Support with Palliative CareBegins as early as the day of diagnosisAvailable at any stage of dementiaCan be provided alongside other treatmentsFocuses on symptom relief, pain management, andemotional supportDementia Care Program services based on eligibilityIf your loved one has beendiagnosed with dementia orAlzheimer’s, additional support isavailable through our DelawarePalliative program. If eligible,patients may be able to enroll inboth programs to receive enhancedsupport for serious illness.Palliative CareGet the support you need.Call us today! 855-335-4677