Rethinking dementia support at home: bridging gaps between healthcare and the social domain

Dementia poses a rapidly increasing global and national challenge, with growing demands on home-based care systems, families, and communities. Although policies encourage people with dementia to remain at home, current support structures remain fragmented, reactive, and overly medicalized. As a result, opportunities to promote autonomy, social participation, and well-being are often missed. This study examines how professionals in healthcare and the social domain experience the organization, collaboration, and quality of home-based dementia support, and identifies ways to improve coordination and awareness of innovative social initiatives.

A qualitative study design grounded in Interpretative Phenomenological Analysis (IPA) was used. Data were collected through seven focus groups and nine individual interviews with 31 professionals from healthcare, social care, community services, and municipal organizations across the Netherlands. Interviews and focus groups were transcribed and analyzed following Graneheim and Lundman's six-step qualitative content analysis.

Professionals described dementia support as a "landscape of isolated islands," marked by minimal interprofessional communication, inconsistent collaboration, and unclear responsibilities. Support often starts too late, focuses predominantly on medical needs, and insufficiently addresses everyday routines, autonomy, and social participation. Limited dementia-specific knowledge across sectors contributes to patronizing communication and reduced involvement of people with dementia in decision-making. Resource constraints-including staff shortages, time pressure, and bureaucratic barriers-further hinder continuity and person-centred support. Participants highlighted the effectiveness of simple, familiar, and inclusive social activities embedded in daily life, and emphasized the need for proactive promotion and a recognizable coordinating professional, such as a practice nurse, case manager, or occupational therapist.

Improving home-based dementia support requires stronger cross-sector collaboration, earlier and more proactive interventions, and enhanced coordination across health, social, and municipal systems. Embedding simple, meaningful, and community-based activities within everyday life, supported by knowledgeable and trusted professionals, is essential to fostering autonomy, participation, and quality of life for people living with dementia at home.