For decades the response to dementia has largely been built around services with assessments, memory clinics, care packages, specialist nurses and care providers all playing an important role. Yet despite this (seemingly) adequate infrastructure, many people with a dementia diagnosis are not well supported due to a lack of resources, facilities and a culture that is largely prejudiced against them.
After more than 25 years operating nursing homes across Devon (and specialising in dementia care for 17 of these years) we have seen first-hand that living well with dementia is not determined solely by the quality of services available. It is shaped just as much by relationships, attitudes and the extent to which people remain connected to the communities they call home.
The challenge is when someone receives a dementia diagnosis. Society often begins to see the condition before the person. For the individual concerned this often means expectations change, confidence is lost (by them and those around them) and social circles can shrink. In this way, many people living with dementia become disconnected from the people and places that give their lives meaning before their dementia starts to progress.
One of the greatest challenges facing dementia care is that responsibility is spread across numerous organisations and individuals; the NHS, local authorities, mental health services, GPs, home care providers, residential care providers and voluntary organisations. The result is a fragmented system, which can be difficult to navigate.
Supporting someone to live well with dementia cannot be the responsibility of any single organisation – it should be a shared responsibility between care providers, families and society. It’s only by doing this, we can build systems to support people to live fulfilling lives with dementia rather than operating systems that simply manage dementia as if it’s a problem. Dementia care is strongest when formal support and community support work hand in hand.
For the past 13 years, Southern Healthcare has embraced the Butterfly Approach developed by dementia care specialist David Sheard. Based on the pioneering work of Professor Tom Kitwood, the approach focuses on understanding feelings, relationships and emotional wellbeing, not simply clinical needs. Its central principle is straightforward, ‘feelings matter most’ – and don’t they just.
Qualifications, procedures and assessments are important, but they are not enough on their own. Environments built around positive relationships consistently produce better outcomes than those built solely around routines and tasks. When people feel understood, valued and emotionally secure, they are more likely to remain engaged in life and experience a greater sense of wellbeing.
The same principle extends beyond care settings. Communities – who understand dementia and respond with patience, kindness and acceptance – enable people living with dementia to continue participating in everyday life for far longer than many assume possible.
A truly dementia-friendly community is a community where people living with dementia continue to be seen, heard and included. It is where shopkeepers, neighbours, businesses and public services understand enough about dementia to respond with confidence rather than discomfort. It’s where people are not defined by their diagnosis, but recognised for their continuing contribution and value.
Unfortunately, many people living with dementia still feel patronised, excluded or treated differently following diagnosis. In some respects, society has become better at talking about dementia, but more needs to be done to ensure we continue to engage in a meaningful way with those individuals living with dementia.
This requires a cultural shift towards acceptance, empathy and inclusion. Do we listen intently? Do we avoid judgement? Do we treat people living with dementia with trust, love and kindness? Often, I would argue we don’t support people living with dementia well enough. We seem to tolerate ageism (or more specifically dementia-ism) where negative attitudes are displayed towards a person living with dementia.
Care and nursing homes have a significant role to play in strengthening communities by inviting communities into our homes, as well as taking residents out into the community. Far too often, care homes are viewed as destinations people move to when community life ends. We believe the opposite should be true. Care homes should act as community assets, bringing people together rather than creating barriers.
At Southern Healthcare, local schools, volunteers, community groups and families regularly interact with our residents and everyone benefits. Residents maintain meaningful connections and communities develop a greater understanding of dementia. Our nursing homes have become a valued part of local life within their communities through public relations, events and building relationships with people who live and work nearby.
The closer we bring communities and residents together, the more we normalise dementia and challenge the isolation so many people experience. It’s about creating environments where people feel respected, valued and loved. Living well with dementia is not simply about receiving care – it’s about continuing to belong.
This article was written by Geoffrey Cox for Care Talk Magazine and first published in October 2026. For practical advice about a dementia diagnosis click here.