Rethinking a framework for dementia 2: a new model of care

This is the second of two papers that aim to propose a revised model of care for dementia based on the combined findings of a number of projects undertaken by the authors.

The paper is a conceptual discussion based on the findings from a series of projects in which the key methodologies included listening to people with dementia and carers, non‐participant observation of services, and reviews of good practice, policy and literature.

The paper challenges traditional approaches to dementia services, and offers a radical new approach, based on a five‐pronged model of care: guiding principles, the condition itself, the person with the condition, services and effectiveness.

This paper challenges commissioners and service planners to make a radical shift in their approach to dementia, people living with it and services and opportunities that should be in place. It proposes that dementia services should be delivered principally in the community, led by primary care, with opportunities for inclusion and social engagement. Specialist dementia services need to refocus on providing effective interventions, training, advice and support. People living with dementia have assets as well as needs; this means changing practice to work alongside people as partners in care, nurture their capacity and capabilities and recognise and pre‐empt increasing needs.

The revised model of care implies a radically different approach to commissioning, designing and delivering services. It is a challenging, but optimistic, model, in which high quality, focused, cost‐effective services and community developments could work together as a whole system, to make living well with dementia a real possibility.