The Future of Dementia Care: Trends, Predictions and Hopes

Dementia is a syndrome that causes cognitive decline and can affect our memory, behaviour, speech, thoughts and feelings. According to the NHS, 1 in 11 people over 65 are living with dementia and this number is growing as people live longer. Cases of dementia in the UK are predicted to reach 1 million in the next few years. Across the world, an estimated 55 million people live with dementia, incurring a global societal cost of approximately US$1.3 trillion. 

Dementia is a progressive condition that generally gets worse over time. If you or someone you love is living with dementia, increasing amounts of intervention and support may become necessary to perform daily activities such as cleaning, shopping, washing and organising finances. Sometimes, living independently with dementia will become impossible. 

There is currently no cure for dementia, although with the correct treatment and support, the progression of the illness can be slowed down, allowing people to retain their mental capacity for longer. In this article we will look at some current trends in dementia care, as well as some predictions and hopes for the future. 

Current Trends in Dementia Care

Person-centred care approaches

Person-centred care places a person at the heart of their care and treats them as an individual. It ensures that, as far as possible, decisions are made with their best interests at heart. 

Core principles of person-centred care include:

• Treating a person with dignity and respect
• Acknowledging and understanding a person’s culture, history, preferences and lifestyle (e.g. their hobbies, interests, likes, dislikes, aversions, triggers, religion etc)
• Trying to view a situation from the point of view of the person with dementia
• Providing enrichment opportunities (such as conversation and interactions with others, days out, the chance to take part in activities or try new things)

Using a person-centred approach in dementia care can help to manage behavioural and psychological changes and reduce conflict. Person-centred approaches also make people feel more valued and cared for which can encourage them to engage with their treatment plan and have a more positive outlook.

Technology integration

Technology can help in the day-to-day lives of people living with dementia who may struggle with their memory, getting out and about and staying safe.

Assistive technology for memory problems includes:

• Setting alarms and reminders on your smartphone or tablet for appointments, medication, meetings, special events etc
• Automatic pill dispensers that sound an alarm when it is time to take your medicine and dispense the correct amount
• Locator devices, such as air tags to help find things that get lost
• Virtual and voice commanded assistants that can remind you of the date, time and year, as well as perform other tasks

Technology that can help you to stay connected and feel less lonely includes:

• Phones, tablets and computers (calls, messages, emails etc)
• Video chat applications (such as Skype, Zoom, Facetime etc)
• Online videos (if you are struggling to get out of the house, you can watch videos and tours of just about anywhere in the world on sites like YouTube)
• Social media platforms and online forums where you can talk to others, view and share updates and stay up to date with current events
• Adapted equipment (such as phones with extra-large buttons or remotes with voice control)
• Sensory devices (such as bubble tubes, colour changing lights or sensory cushions)
• Digital games, puzzles and apps that can help you to keep your mind active, problem solve or can be used for relaxation
• Mindfulness or meditation apps to help you to stay calm and centred
• Digital photo frames
• Robot pets and companions
• Voice-activated assistants that you can command to put on the radio, play a certain song etc

When someone is experiencing cognitive decline, they become increasingly vulnerable. They may be more likely to fall, wander off in the middle of the night or be less able to assess risk. Assistive technology is also available to keep them safer and to give their family members and carers additional peace of mind.

Technology to enhance safety includes:

• Motion sensors and door alarms
• Fall sensors
• Temperature sensors and thermostats
• Tracking apps or location monitoring devices
• Ring cams, doorbell cams or nanny cams
• Water isolation devices
• Automated shut-off devices
• Personal alarms

No one item of technology is going to make an environment completely risk free; devices and technology should always be used with additional safeguards and supervision in place.

Increased family involvement 

Involving family and friends in a person’s care has been shown to improve patient outcomes. People who knew the person with dementia before they had the condition are best placed to speak to nurses and caregivers to tell them vital information that can inform their patient-centred care.

Family and friends can provide an extra level of support to make sure that a person with dementia understands key parts of their care plan, such as their medication and treatment options. If a dementia patient has to enter a care home or nursing home, regular contact with family and friends can provide some continuity and make them feel less scared and abandoned.

Strategies to increase family involvement in dementia care include:

• Regular conversations between nurses/carers and family and friends
• Making sure that family members are listened to and feel included
• Letting go of bias and prejudice
• Using plain language and avoiding technical terms and jargon or explaining them clearly
• Finding different ways of sharing information when people are located far away (phone calls, emails, photographs etc)

Holistic and multidisciplinary care 

Outcomes are better for dementia patients when a multidisciplinary approach is taken. Dementia is a complex condition that can impact a person physically, mentally, socially and emotionally. A multidisciplinary approach will involve collaboration from a number of different individuals and specialists, including:

• Psychiatrists
• Neurologists
• Dieticians
• Nurses
• Carers
• Occupational therapists
• Speech and language therapists
• Physiotherapists

A multidisciplinary approach allows for different aspects of a person’s wellbeing to be considered and for their complex needs to be met by people who each bring different, but essential, skills to the table. 

Predictions for the Future of Dementia Care

Advancements in research and treatments

In August, a first of its kind drug was licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) to treat mild symptoms of cognitive impairment associated with Alzheimer’s. Unfortunately, Lecanemab is expensive, estimated to cost around £20,000 per patient per year. NICE has decided that the benefits are too small to justify the cost, meaning that the drug will not be available on the NHS to the approximately 70,000 people who would have been eligible for it.

Research into drugs that will slow down the progression of dementia and Alzheimer’s is ongoing and, hopefully, a more cost-effective version will be developed that can become widely available to everyone who needs it.

Enhanced training for caregivers

As people live longer and more of them are being diagnosed with dementia or showing signs of serious cognitive decline, specialist training in how to care for these patients is becoming increasingly necessary. 

The Covid-19 pandemic caused a shift in public attitude towards the care sector, which had previously been seen by many as an unskilled, low-level profession. As respect for carers has increased, many workplaces have followed suit and begun to encourage workers to value professional development. Some workplaces now incorporate training beyond the Care Certificate to advance the levels of care that are provided and provide carers with skills that extend beyond the basics. 

Enhanced and specialist training for caregivers is essential to enable them to provide the right care to patients and to make competent decisions. Continuous learning beyond the Care Certificate needs to become more normalised and, in the future, hopefully more care facilities will start to offer carers enhanced training as standard.

Community-based support models

Landais Alzheimer in south-west France is a village with a difference – all of its inhabitants have dementia. There are around 120 villagers there, with the same number of healthcare professionals plus volunteers.

• The village shop has grocery items for sale but no money is required which takes the stress out of remembering your purse or budgeting
• Villagers live in groups of up to eight, with communal kitchens and living spaces to promote socialising
• There are no set hours for visiting, allowing people to come and go as they please
• The village has amenities including a restaurant and villagers are encouraged to engage in activities, such as visiting the theatre

Prof Hélène Amieva is among the experts who are monitoring the effects of this unique social situation and preliminary findings are positive, so far showing positive outcomes for families and patients alike. Usually, cognitive decline is seen when people enter a care home or other institution, but that has not been the case in Landais Alzheimer. 

A similar approach has been taken in Warwick, England, inspired by a purpose-built Dutch facility – The Hogeweyk Dementia Village. Residents can reside in the Woodside Care Village, designed to look and function like a mini town, and enjoy the benefits of higher than average ratios of carers to patients.  

These types of community-based facilities have been found to reduce levels of loneliness, aggression and depression in dementia patients, in addition to slowing down cognitive decline. More countries are now looking into these successful models and considering opening up their own, similar facilities. 

It is possible that these types of dementia-friendly villages may become a more integrated part of person-centred care in the future. 

Policy and advocacy efforts 

Organisations and charities such as The Alzheimer’s Society work on a local and government level to influence policy changes aimed at improving the quality of life for people with dementia.

Many advocates for people living with dementia want to see:

• Better social care, including a more cohesive service with fewer regional variations in standards and availability of care
• More funding for dementia care and research
• New and bold targets for dementia diagnosis to benefit the approximately 30,000 undiagnosed people living with dementia in the UK
• Greater transparency within the NHS on their plans to deliver disease-modifying treatments and earlier diagnosis
• Increased public understanding around risk factors, prevention and the importance of earlier diagnosis through targeted campaigns

Around 60% of people with dementia around the world are from low- or middle-income areas according to the World Health Organization (WHO). Global improvements in dementia care may go hand in hand with more general ‘levelling up’ initiatives that address poverty and inequality. 

Hopes for Dementia Care 

Improved quality of life 

Improving the quality of life for people with dementia is a fundamental goal in dementia research. As new treatments, strategies and medicines are developed and trialled, we can hope for:

• Dementia sufferers to live longer and more healthy lives
• Supportive environments to be created that provide joy and positivity to people with dementia and their families
• New medicine to be discovered that is more effective than current options and has fewer side effects

Increased public awareness of dementia is also key to improving the quality of life for dementia patients and developing a culture of prevention and help-seeking behaviour. 

Greater public awareness

Increasing public awareness around dementia can help to:

• Reduce misunderstanding and stigma around the condition
• Lower rates of loneliness and isolation among the elderly
• Empower people so they feel confident speaking to people with dementia and able to offer them the right sort of support

Although there is no specific way to prevent dementia as research is still ongoing, there is evidence that suggests living a healthy lifestyle can reduce the risk of cognitive decline and will keep you healthier for longer in your old age. 

Increased public awareness of risk factors relating to dementia means earlier intervention is possible.

Risk factors may include: 

• Age
• Genetics
• Air pollution
• Loneliness and isolation
• Hearing loss
• A sedentary lifestyle

We talk a lot about keeping our body healthy, but there is a lack of public awareness about how to keep your brain healthy. It is vital that people take steps to prevent cognitive decline, for example:

• Eating a healthy balanced diet, staying hydrated and maintaining a healthy weight
• Exercising regularly and staying active (this does not have to be high impact. If you have mobility issues or struggle to exercise, consider some gentle stretches, seated yoga or tai chi)
• Stopping smoking and avoiding drinking more alcohol than the recommended weekly limits
• Finding ways to manage stress and anxiety and maintaining a healthy blood pressure (e.g. deep breathing exercises, meditation or journaling)
• Socialising and doing things that you enjoy
• Keeping your mind sharp by doing puzzles and crosswords, watching game shows or trying out brain training apps

Innovative therapeutic approaches 

In conjunction with traditional medicine and care plans, we may soon begin to see some new therapeutic approaches being used. 

Although they cannot directly treat the symptoms of dementia, alternative therapies can be used to enhance quality of life, promote relaxation and happiness, improve sleep and boost mental health. 

Alternative therapies to consider include:

• Art and music therapy
• Aromatherapy and massage
• CBD oil
• Light therapy
• Transcutaneous electrical nerve stimulation (TENS)

Technological innovations, such as virtual reality or simulation, may also become incorporated into dementia care. VR headsets can allow people with dementia to immerse themselves in the past or to feel that they are having new experiences when they are struggling with mobility.

Global collaboration

Dementia affects people in every continent and as the global population ages, it becomes a more pressing issue on societies, families and healthcare systems worldwide. Increased communication, sharing of information and collaborative research are needed to address the prevalence of dementia. 

At the 2024 G7 Ministerial Meeting, a side event is being hosted called Advancing Global Collaboration for Dementia and Healthy Aging, aimed at emphasising:

• Progress made so far on all fronts (policy advances, innovation, improvements in care etc)
• The need for global collaboration in healthy ageing and brain health
• Highlights of the progress that has been made since the 2023 G7 meeting in Japan that supported ‘policies and resources to care for people living with dementia’

The event will be attended by government officials, experts, policymakers and other stakeholders and will hopefully move us one step closer to global harmony in dementia care, improving outcomes and quality of life for all.

Conclusion

As advancements are made in care, technology and medicine, the quality of life of dementia sufferers will improve, and one day we hope that a cure for this debilitating illness will be found. You can keep up with new trends and advancements in dementia care by checking out the World Dementia Council website. There, you can read about the discussions that were had when 150 experts gathered in London for the 2024 WDC summit to share information about what the next decade may hold in terms of brain health and related therapies.