Towards a Community-Based Dementia Care Strategy: How Do We Get There from Here?

Area of Science:

• Gerontology
• Public Health Policy
• Dementia Care Research

Background:

• Most older adults, including persons living with dementia (PLWD), prefer to age in place.
• Many PLWD transition to residential long-term care (LTC) or hospitalization, often due to a lack of community support.
• LTC is appropriate for advanced dementia but can be a costly, avoidable outcome for those needing community-based services.

Purpose of the Study:

• To explore the current state of community-based dementia care.
• To analyze dementia care policy in Ontario as a case study for systemic challenges.
• To identify strategies for a community-based dementia care model.

Main Methods:

• Literature review on the "state of the art" in community-based dementia care.
• Historical policy analysis of dementia care in Ontario.
• Application of a "balance of care" study framework in South West Ontario.
• Synthesis of national and international dementia care strategies.

Main Results:

• Early and ongoing intervention in community settings is vital for persons living with dementia (PLWD).
• Lack of accessible community care options often leads to premature or default placement in institutional settings.
• Policy shifts are needed from reactive, curative care to proactive, community-based prevention and maintenance.

Conclusions:

• A community-based dementia care strategy requires engaging PLWD in care decisions.
• Support for informal caregivers is essential for the success of formal care systems.
• Policies must enable "ground-up" change, ensuring early intervention and a continuum of care to promote independence closer to home.