By: Sloane Airey
It’s still not clear how the incoming administration of President Donald Trump will affect the senior living industry – but memory care experts are optimistic that his aging voter base could mean bipartisan support for Biden-era programs and initiatives.
The latest Trump presidency coincides with the country’s largest age cohort – the Boomer generation – aging into their elder years. In the next five years, the U.S. Census Bureau estimates there will be 19.5 million Americans turning 80 years or older and all Boomers will be 65 or older.
Memory care operators have prepared for a big year in 2025 by readying new plans to grow and evolve with the times. The incoming administration serves as a point of uncertainty for the year ahead, especially given that Trump has vowed to enact steep tariffs and engage in mass deportations nationwide. The incoming White House seeks to target government programs it deems wasteful via the new and controversial Department of Government Efficiency and the civil servant elimination plans laid out in Project 2025.
That said, there are hopes within the U.S. memory care sector that the incoming administration won’t rock the boat much with regard to programs established under Biden. That includes the GUIDE model, which created new training and support for in-home caregivers and around-the-clock support along with a new form of payment for participating providers to coordinate care.
Experts who spoke with Memory Care Business cited the program’s success in reducing costs and its use among older adults over 50, a majority of whom voted for Trump in the 2024 election, as two big reasons why they think the incoming administration won’t be too hasty in rolling back the program.
‘We’ve got a big challenge ahead of us’
Among the companies forging ahead with a plan to offer new services through the GUIDE model is Rippl Care, a behavioral health startup that offers around-the-clock support and personalized care to older adults and their families and caregivers.
Rippl Founder and CEO Kris Engskov noted that the demand for better services for people living with dementia is great given that one out of three older adults age 85 and older have an Alzheimer’s diagnosis.
“We’ve got a big challenge ahead of us,” Engskov told Memory Care Business.
The Seattle-based company aims to keep dementia patients out of the emergency department with the goal of reducing healthcare costs and patient stress. It partners with health systems and other organizations working with Medicare Advantage plans, accountable care organizations and other “payviders” to deliver dementia care services through value-based care arrangements.
It’s a care model built off of the same data that led the Centers for Medicare and Medicaid (CMS) to create the Guiding an Improved Dementia Experience (GUIDE) model.
CMS launched the GUIDE model in 2023 to pilot new ways to care for the rapidly growing number of people with dementia. Like Rippl, GUIDE aims to help individuals with dementia to remain in their homes longer and maintain better health. The program provides training for in-home caregivers and offers them 24/7 support, and it introduces a new payment system for participating providers to improve patient care coordination. GUIDE also offers a $2,500 respite voucher for at-home caregivers.
By mid-2024, over 400 healthcare organizations were participating, including United Church Homes, Bella Groves and Lutheran Senior Services.
But GUIDE is also an outgrowth of the Biden-Harris administration and its stated goals to extend support for Americans with dementia and their families. Considering Trump’s vows to undo many parts of the previous administration’s legacy – and his controversial appointments to CMS and its parent agency, the Department of Health and Human Services – it’s logical to wonder whether programs like GUIDE could end up on the chopping block.
That said, experts who spoke to Memory Care Business said there’s reason to be optimistic about GUIDE and the larger memory care industry during the Trump administration.
Given the importance of the baby boomer generation voting bloc to Republicans and their rapidly increasing need for memory care. At Home Harmony Founder Will Saunders told MCB in an interview that, “we believe it is highly unlikely CMS and the Trump Administration alters course on the GUIDE program and its core initiative of providing more support to individuals living with dementia and their family caregivers.”
Engskov with Rippl Care agreed: “Certainly from our viewpoint, this is a proven model that delivers great clinical outcomes and reduces cost, and those are the two things we have to do right?”
Saunders points out that the GUIDE model can help reduce unnecessarily dementia-related hospital visits and ultimately reduce Medicare expenses – savings that could be appreciated by Republicans.
“GUIDE is the first program CMS has driven for whom the primary constituent is not solely the patient,” he explained. “This is because CMS knows excess healthcare utilization occurs when the family is exhausted and stressed.”
One way Republicans have traditionally favored tax cuts or credits over social programs, aimed at providing the same benefit to citizens. And Trump did tout a new tax cut during the campaign trail which would offer a $5,000 tax credit to people taking care of family members at home. However, experts said in an ideal world, this tax cut would augment programs like GUIDE instead of replacing them.
“I think the tax credit is potentially a really interesting idea, because it does incentivize a certain kind of behavior that allows these caregivers the time they need to actually stay at home, and the financial support that they might need,” said Engskov. “Because a lot of them are not going to have a choice.”
Trump’s proposed changes to the U.S. immigration and tariffs could make memory care even more unaffordable than it already is for many Americans. Depending on what and who they target, new tariffs could increase the price of the new tech providers are eager to embrace and make new construction projects less likely to pencil out. Putting aside human rights, stricter immigration laws could make it more difficult for senior care center operators to hire the 1.2 million workers needed to care for older Americans by 2030.
‘The wave is here’
Since the GUIDE model’s official rollout last year, Rippl Care has expanded its GUIDE participation across five states. Engskov shared that its virtual nature means the program has helped reach new patients and their caregivers who would otherwise not be served at all.
“We don’t have to see people in person for the most part, and that allows us to get to places that are very difficult to serve, to see people in small towns and big cities,” he said.
Saunders also lauded the model so far, sharing that it “exceeded our expectations” with the majority of caregivers he’s spoken to about it “enthusiastically” enrolling to participate. He shared several stories of how the model has helped caregivers, including by teaching them how to better care for people living with dementia. For example, Saunders shared how one participant learned new techniques to help feed his wife who are having trouble eating due to the disease.
GUIDE model participants also have access to support groups where they can share their experiences, and GUIDE has provided respite funds to participants that have helped augment care in other ways.
Still, no pilot program is perfect: Saunders noted the GUIDE model is “administratively complex” and may be a challenge for participants to navigate. But experts remain optimistic that the GUIDE model can help demonstrate the need for more federal investment into memory care programs and solutions across the political aisle over the next four years.
“I don’t know that we’re going to get ahead of it, because it’s here. The wave is here,” said Engskov of the millions of Americans rapidly aging into memory care.
“We have an opportunity, we know how to do this,” he said. “We’ve got some great evidence-based best practices that have been pioneered over the last ten years, and now we just need to build it at scale.”