Application for Membership in Dementia Care Alliance

Application for Membership

*Name of Home Care Agency:
*# Clients with Dementia:

*Shipping Address:


*Name of Contact:

*Title:

*URL to Link to From DCA Membership Page:

*Email:

*Phone Number:


*By checking this box I certify that I have the authority to represent the above home care agency in applying for membership in Dementia Care Alliance. I also certify that I have the authority to commit the above home care agency to the Terms of Membership as stated below and to abide by same.

(After clicking the Submit button, your agency will be registered in the DCA database. However, membership will not become effective until you complete the following items:
1) Order the first 5Pak of My Frame of Reference™ and I Care (You will be redirected to the order page after you click the Submit for Membership button below.)
2) Schedule your organization's 4 quarterly training sessions with Engaging Alzheimer's LLC (You will receive a Welcome Letter via email within 48 hours of ordering the 5Pak. This email will contain the name and telephone number of your assigned Dementia Coach so that you can call to schedule your 4 training sessions.)
3) Send us your logo in hi-resolution (300 dpi) PDF format so that we can create and print your 100, 4-color Personalized Marketing Flyers (You will be billed for this order upon delivery.)

Terms of Membership

  1. dca logo

    Membership is only available to those home care agencies that demonstrate a concerted effort to learn the needs of those with dementia and apply best-care dementia practices as deemed by Engaging Alzheimer’s LLC. Further, the agency must commit to on-going, tangible, and measurable levels of care for their clients with cognitive impairment.

  2. Each qualified agency will have the right to display the DCA membership insignia on their website(s) and in their marketing material. Membership is re-evaluated annually.
  3. Each member agency (The Agency) shall maintain a supply of My Frame of Reference™ frames and copies of I Care and provide the 2-Frame set and I Care book as a gift to every client that has Alzheimer’s or a related dementia.
  4. The Agency must orient in-home staff to use My Frame of Reference™ to better relate to the client and better serve the needs of the client.
  5. The Agency shall notify their clients with dementia about the Agency's partnership with Engaging Alzheimer's LLC within 30 days of membership approval. 
  6. The Agency must retain Engaging Alzheimer’s LLC for a minimum of once per quarter for a one-hour educational training session with staff in best-practices dementia care and/or to discuss strategies and resolutions for client challenges. The rate for these trainings is $225 per hour and any part thereof after the initial hour. Failure to meet the requirement for training in one or more quarters is grounds for immediate removal of Agency's listing in the DCA Directory. Continued failure to meet the training requirements is grounds for loss of membership.
  7. Upon initial purchase of the My Frame of Reference™ 5-Pak, consisting of 10 frames, 5 Personal Information inserts, 5 Personal Care inserts, and 5 copies of I CareA Handbook for Care Partners of People with Dementia, The Agency shall be registered for membership in Dementia Care Alliance database.
  8. Revocation of The Agency’s membership shall occur automatically, if and when The Agency fails to fulfill the requirements of Terms of Membership in whole or in part.
  9. Upon notification of revocation of membership by Engaging Alzheimer’s LLC, The Agency shall, within 48 business hours remove any and all reference and affiliation with Dementia Care Alliance and Engaging Alzheimer’s LLC from The Agency’s web site(s), marketing material, physical property, documents, emails, and any other location and/or document which would indicate or imply a formal relationship with Dementia Care Alliance and/or Engaging Alzheimer’s LLC.
  10. The Agency has the right to cancel membership in Dementia Care Alliance upon 30 days written notice to Engaging Alzheimer’s LLC. Upon receipt of The Agency’s cancellation notice, Engaging Alzheimer’s LLC shall remove The Agency’s information from the roster of members located on Engaging Alzheimer’s LLC’s website.
  11. Gold Standard Membership will not be awarded to any agency, regardless of the number of points earned, unless and until the agency has successfully completed 12 consecutive months of membership.
  12. The Agency, upon acceptance into the Alliance, will be listed in the Alliance’s online Membership Directory. For those agencies that have achieved Gold Standard status, the Gold Standard icon will be placed next to the agency name in the DCA directory.
  13. Additional expenses for on-site trainings include round-trip Travel Time billed at $30/hour or any part thereof, round-trip mileage reimbursement based on $0.55/mile, plus applicable parking, car service, hotel, airfare, train/subway and any other costs incurred.