Skip to main content
NCBI home page
Innovation in Aging logoLink to Innovation in Aging
. 2026 Sep 1;10(11):igag094. doi: 10.1093/geroni/igag094

Community-based solutions: a principles-to-practice framework to support individuals living with dementia and their care partners

Allie Peckham 1,2,✉, Monika Roerig 3,4, Sage Sadow 5, Frances Morton-Chang 6, Laura Schmid 7, Clare Schuchardt 8, Molly Budhiraja 9, Sara Allin 10,11
Editor: Megumi Inoue
PMCID: PMC13645434  PMID: 42847062

Abstract

Background and Objectives

Alzheimer’s disease and related dementias represent a global public health concern, with persistent gaps in supports for individuals living with dementia and their unpaid care partners. This study synthesized promising community-based innovations that address these gaps and contribute to positive outcomes.

Research Design and Methods

A rapid literature review was conducted to develop a framework for guiding the design and evaluation of community innovations for individuals living with dementia and their care partners. 4 databases were searched using keywords related to dementia, care partners, community-based care, and quality outcomes. 22 articles were included, each evaluating a community-based intervention for individuals with dementia and their care partners and reporting outcomes. Cross-study thematic analysis identified programmatic factors associated with success.

Results

The resulting framework comprises 6 programmatic factors of success, 6 design and implementation considerations, and 4 cross-cutting principles. Success factors included early intervention, triadic involvement in planning, individualized and person-centered approaches, multi-component interventions, community-building activities, and direct care partner resources and tools. Design and implementation considerations included target population, delivery models, co-design strategies, resource allocation and system incentives, geographic context, and impacts and outcomes. Core principles emphasize anti-stigma, accessibility, equity and intersectionality, and sustainability.

Discussion and Implications

Co-design and sustained community engagement were identified as central strategies for reducing stigma and fostering inclusive, dementia-supportive environments. The framework can be used to support the development, investment, and scalability of effective community-based supports for individuals living with dementia and care partners across diverse settings.

Keywords: Community-based care, Aging in place, Dementia care framework, Sustainable care models, Rapid literature review

Innovation and Translational Significance:

As aging in place is increasingly prioritized and the number of people living with dementia grows, there is a need for guidance on the key factors that make community-based interventions more effective. Using a rapid review of the literature, we identified common programmatic features that contribute to positive outcomes for either individuals living with dementia or their care partners. These findings informed the development of a practical framework to guide the design, evaluation, and refinement of community-based supports. This framework offers actionable direction for policy, practice, and evidence-informed models of care to strengthen dementia-inclusive environments.

Background and objectives

Globally, it is estimated that 55 million individuals are affected by Alzheimer’s disease and related dementias, a figure projected to triple by 2050 (Alzheimer’s Association, 2025). As dementia prevalence rises, the responsibility for day-to-day care increasingly falls to unpaid care partners, most often family members, who have been estimated in the United States (US) to provide about 18.4 billion hours of care to individuals with neurocognitive disorders (U.S. Centers for Disease Control and Prevention, 2025). These care partners play a vital role in preserving the health, quality of life, and independence of those they support (USAging, 2024), yet they also bear significant emotional, physical, and financial burdens as a result (Watkins & Overton, 2024). The number of individuals living alone with dementia is also increasing across the world, with growing and unique needs that are poorly understood (Crance & Yu, 2025). As the global population ages, dementia has become a critical public health concern, with significant physical, financial, and emotional implications for families, communities, and health care systems. Therefore, (re)designing health and social care systems to address these challenges is essential (USAging, 2024; Yu et al., 2025).

Aging in place, or the ability to remain in one’s home and community while aging, has emerged as a global policy and practice priority (Government of Canada, 2024). Many individuals with dementia worldwide express a strong preference to remain in familiar environments as long as possible (Morton-Chang et al., 2019; Wiles et al., 2012). Aging in place has been associated with enhanced quality of life, stronger social connections, and increased autonomy (Wiles et al., 2012). However, fulfilling this goal is a challenge in many jurisdictions, hindered by limited housing options that support changing physical and cognitive needs, inequitable access to appropriate health and social services, and insufficient care partner support (Morton-Chang et al., 2019).

Developing and integrating community-based innovations to support aging in place represents a “wicked problem”: a complex, deeply interdependent, context-sensitive challenge without a singular or simple solution (Head & Alford, 2015; Mason & Mitroff, 1981). In high-income countries (i.e., the US, the United Kingdom (UK), Canada, and Sweden), these efforts are further complicated by siloed and poorly coordinated health and social care systems that lead to service gaps and limit meaningful community-based alternatives to institutional care (Agonafer et al., 2021; Melin Emilsson et al., 2022).

Rising health care costs and constrained public budgets further complicate the delivery of integrated, person-centered supports. In response, multi-sectoral partnerships have emerged as a promising strategy to address these complex, systemic challenges or “wicked problems,” offering mechanisms to bridge gaps between services, pool resources, and support innovation (Blanken & Dewulf, 2010). Despite this potential, there remains limited evidence to guide the development, implementation, evaluation, and long-term funding of current community-based practices in ways that identify gaps and inform opportunities for effective cross-sectoral collaboration. Clarifying which features and structures enable community-based innovations to effectively address and support the health and well-being of individuals living with dementia and their care partners is essential for achieving scalable impact (Crance & Yu, 2025).

This paper aims to identify the core programmatic features and design considerations that contribute to positive outcomes in community-based dementia care innovations. Although community-based programs can vary widely in structure, setting, and intensity, there are common foundational models that may transcend context (Peckham et al., 2022). Synthesizing these shared elements across diverse programs and populations offers an opportunity for an evidence-based foundation for strengthening future innovation. Drawing from a rapid review of the literature (Peckham et al., 2025), we present a framework to guide the development, evaluation, and adaptation of equitable, dementia-inclusive community innovations. This framework also offers structured guidance for identifying gaps in existing programs and informing opportunities to strengthen or develop dementia-inclusive community-based innovations across varying health and community contexts.

Research design and methods

We completed a comprehensive rapid literature review (Dobbins, 2017; Tricco et al., 2015) to identify literature evaluating community-based interventions to inform the development of a guiding framework that can be applied to strengthen or design future community-based interventions supporting individuals living with dementia and their care partners. A rapid review approach was selected because this project was conducted in partnership with a community organization seeking timely, evidence-informed guidance to support near-term investment and planning decisions. The study aimed to identify cross-cutting programmatic features, rather than to evaluate the effectiveness of specific programs. Rapid review methodology aligns directly with this aim, as rapid reviews are an established and rigorous method for producing actionable, practice-relevant insights in applied health and social care contexts, particularly when informing system-level innovation (World Health Organization, 2017b). This approach differs from systematic reviews, which typically involve exhaustive searches and formal quality appraisal to assess intervention effectiveness. It also differs from scoping reviews, which aim to map the breadth of available literature, and narrative reviews, which often lack structure and provide an overview of a topic (Bouck et al., 2022). This approach is particularly useful when the objective is to identify broad themes, implementation considerations, and promising programmatic features rather than to evaluate the effectiveness of specific interventions.

Literature review

Searches were conducted across four electronic databases for articles published up to September 2025. The databases were selected to ensure broad interdisciplinary coverage of dementia care literature, including medical (Medline), nursing and allied health (CINAHL), psychological (PsycINFO), and social sciences (Scopus). This approach allowed us to capture a spectrum of dementia care interventions, including clinical and community-based interventions. We used consistent search terms related to the concepts of dementia, care partners, community-based care, and quality outcomes (see Box 1). The search strategy focused on broad concepts of home and community-based care rather than specific program types (e.g., respite, adult day services, meeting centers, and green care farms), as we aimed to identify cross-cutting programmatic features across diverse community-based interventions by capturing a wide range of service models rather than limiting the search to predetermined or traditional categories of community support.

Box 1.

Search syntax.

(dementia OR Alzheimer OR neurocognitive disorder OR neurodegenerative disorder) AND (unpaid caregivers OR carers OR informal caregivers OR family caregivers OR caretaker OR care partner) AND (home and community care OR community-based care OR home care services OR home-based care) AND (caregiver support OR dementia support) AND (quality of life) AND (satisfaction) AND (quality of care).
Open in a new tab

Search results were imported into Rayyan, an online application for systematic reviews, for initial deduplication and screening. Three research assistants (SS, KM, and CES) collaboratively removed duplicates and performed two phases of screening (title/abstract and full-text). Articles were included if they were: (a) published in English and peer-reviewed; (b) evaluated a community-based innovation, defined as a non-institutional program delivered in home or community settings that promotes aging-in-place values such as autonomy, familiarity, social connection, and the ability to remain and engage with one’s community; this excluded interventions offered in institutional settings and those focused solely on pharmacological or clinical treatment without a community or psychosocial component; (c) targeted individuals living with dementia and/or their care partners; (d) assessed and reported outcomes for either group; and/or (e) included a needs assessment related to community-based care, defined as studies that systematically identified unmet needs, service gaps, preferences, or lived experiences of individuals living with dementia and/or their care partners to inform community-based service design, delivery, or evaluation. Inclusion and exclusion decisions were made through consensus; unresolved cases were reviewed by the lead researcher (AP). There were no geographical limiters associated with our search.

Data were extracted using an extraction table capturing author(s), year, location, study design and methods, target population (including dementia stage if noted), intervention components, outcomes, and evaluation methods (see Supplementary Material). Four research assistants (SS, KM, LS, and CES), with support from the lead author (AP), completed the extraction.

Data were systematically organized, with attention to reported outcomes, key intervention elements, implementation barriers and facilitators, and programmatic features associated with positive impacts for individuals living with dementia and their care partners. Positive outcomes were identified when their associated interventions were found to have their intended effects; for instance, reducing care partner stress and burden or increasing cognitive function among people living with dementia. Analysis drew on principles of thematic synthesis and cross-case analysis (Ayres et al., 2003; Jenkins et al., 2018; Thomas & Harden, 2008) and proceeded in four stages to identify, compare, and synthesize recurring patterns in program characteristics, implementation features, and reported outcomes across studies. The unit of analysis was the individual study rather than the intervention itself, as the included literature comprised a mixture of primary intervention studies and review articles synthesizing multiple interventions. Consequently, the analysis focused on identifying recurring patterns in reported intervention features, implementation characteristics, and outcomes across studies. In this context, “comparative” refers to the identification of cross-study patterns rather than a direct comparison between individual interventions.

First, we identified and compared recurring patterns in programmatic features, outcomes, and implementation characteristics across studies. Through an iterative and inductive process, we identified recurring implementation features, such as technological viability, engagement strategies, costs, supports, and care delivery models and approaches. These recurring implementation considerations were grouped into six design and implementation considerations that shaped the feasibility, accessibility, and sustainability of community-based interventions. Second, the implementation considerations were examined alongside reported outcomes to identify recurring programmatic approaches associated with positive impacts across studies. Rather than focusing on individual intervention activities, the analysis sought to identify higher-order patterns that appeared consistently across interventions reporting positive outcomes. Through iterative comparison and abstraction, these recurring approaches were synthesized into six programmatic factors of success. Third, following identification of the implementation considerations and programmatic factors, a deductive review of literature on dementia-inclusive care, health equity, and access was undertaken to situate the findings within broader conceptual and policy discussions (Alzheimer’s Disease International, 2024; Co et al., 2021; Crenshaw, 1991; Draper et al., 2018; Levesque et al., 2013; McCleary et al., 2013; Morton-Chang et al., 2019; Peckham et al., 2018; Public Health Agency of Canada, 2019). This third stage resulted in four core principles and values—anti-stigma, accessibility, equity and intersectionality, and sustainability—which were not used to generate factors of success but rather served as an interpretive lens through which the factors could be understood. Finally, we organized elements into a framework, revising definitions collaboratively, and engaging in focused discussions to clarify factors of success and ensure alignment with both evidence and practice-based knowledge.

An earlier draft of this work was refined by content experts, community organization partners, and individuals with lived experience (n = 4). This process involved sharing draft findings, collecting written and verbal feedback, and conducting a follow-up discussion, all of which informed refinements to the framework’s structure, language use, and emphasis, including attention to diverse needs, non-stigmatizing language, and tailored support across the care trajectory. These efforts supported the development of a guiding framework for identifying gaps in existing programs and for supporting the design of future community-based interventions for individuals living with dementia and their care partners (see Figure 1).

Figure 1.

Graphic showing the three levels of the framework via three concentric rings. The center lists the four core principles and values; the middle lists the six considerations for design and implementation; and the outermost ring lists the six programmatic factors of success.

Open in a new tab

A framework to guide the development and implementation of community programs for people living with dementia and care partners.

Results

A total of 190 articles were identified (see Figure 2). After deduplication, 175 remained for title/abstract screening, where 142 were excluded for not meeting eligibility criteria. The remaining 33 articles underwent full-text review, of which 25 met eligibility criteria (Au et al., 2023; Boyt et al., 2022; Camic et al., 2014; Caprioli et al., 2023; Dahlrup et al., 2014; Draper et al., 2018; Egan et al., 2018; Fauth et al., 2017; Gan et al., 2024; Godfrey et al., 2025; Greenwood et al., 2016; Hanser et al., 2011; Hattink et al., 2015; Kashimura et al., 2021; Leroi et al., 2020; Lewis et al., 2015; Liddle et al., 2012; Mets et al., 2013; Mohide et al., 1990; Rokstad et al., 2019; Shega et al., 2003; Sin et al., 2018; Tamplin et al., 2018; Whitlatch et al., 2019; Ye et al., 2025). These articles were from 19 countries, predominantly high-income, with one from China (a high-middle-income country). Seven were review articles (Boyt et al., 2022; Caprioli et al., 2023; Egan et al., 2018; Gan et al., 2024; Greenwood et al., 2016; Sin et al., 2018; Ye et al., 2025), and only one study (Hattink et al., 2015) appeared in two of the reviews (Boyt et al., 2022; Egan et al., 2018). Of the 25 articles, 12 focused on interventions specific to the care partner (Au et al., 2023; Boyt et al., 2022; Dahlrup et al., 2014; Egan et al., 2018; Fauth et al., 2017; Godfrey et al., 2025; Greenwood et al., 2016; Hattink et al., 2015; Kashimura et al., 2021; Lewis et al., 2015; Mohide et al., 1990; Sin et al., 2018), 5 focused on interventions specific to the care recipient (Caprioli et al., 2023; Draper et al., 2018; Gan et al., 2024; Leroi et al., 2020; Mets et al., 2013), and 8 targeted both populations (Camic et al., 2014; Hanser et al., 2011; Liddle et al., 2012; Rokstad et al., 2019; Shega et al., 2003; Tamplin et al., 2018; Whitlatch et al., 2019; Ye et al., 2025). The eight articles (Corry et al., 2019; Davis et al., 2011; Jones, 2013; Kaufman et al., 2024; Leong et al., 2024; Liu et al., 2021; Wu et al., 2018; Zamani et al., 2023) that did not meet eligibility criteria during full-text review were excluded as they either targeted the wrong sample, did not have an active program/intervention, did not focus on a community-based intervention, or were protocol papers, which describe the methodology of planned studies but do not report findings.

Figure 2.

Articles were identified through Scopus, MEDLINE, CINAHL, and PsycINFO. After duplicates were removed, we conducted title-abstract screening on 175 articles. We conducted full-text screening on 33 articles, 25 of which were included in the final review.

Open in a new tab

PRISMA diagram.

The 25 included articles described a wide range of interventions, such as technology-based programs, care partner supports, co-located case-managed interventions, day programs, dementia-inclusive education, community arts initiatives, home visits and respite, counseling, and mobility services. Many interventions combined components (e.g., counseling with education on dementia, disease progression, and care strategies) and ranged from direct care delivery to broader supportive services. Direct care delivery included interventions such as respite services and mobility services for individuals living with dementia, while other supportive services could include such things as educational programs or counseling programs tailored to individual needs and concerns expressed by dementia care partners. These categories often overlapped, reflecting the complex and multifaceted nature of community-based support for individuals living with dementia and their care partners.

Framework for successful interventions in the community

Based on the reviewed literature, we identified six key programmatic factors associated with positive outcomes for both individuals living with dementia and their care partners. Additionally, we highlight six cross-cutting considerations that can guide the design and implementation of community-based innovations (see Figure 1). These insights should be considered in conjunction with the four core principles, derived deductively from existing work on dementia-inclusive care—anti-stigma (Alzheimer’s Disease International, 2024; Public Health Agency of Canada, 2019); accessibility (Levesque et al., 2013); equity and intersectionality (Co et al., 2021; Crenshaw, 1991; Draper et al., 2018; McCleary et al., 2013; Public Health Agency of Canada, 2019), and sustainability (Morton-Chang et al., 2019; Peckham et al., 2018)—which serve as a foundation for interpreting both the programmatic factors and consideration for implementation opportunities.

Programmatic factors contributing to positive outcomes

The six programmatic factors identified directly influence key desired outcomes, including improved symptom management, delayed or avoidable institutionalization, reduced care partner burden, and enhanced social engagement. Table 1 summarizes the included studies and illustrates how specific programmatic elements were (or were not) described and how they relate to reported outcomes among persons living with dementia and their care partners and across domains such as psychosocial well-being, social and interpersonal functioning, health and quality of life, and service use. These patterns are described in more detail below.

Table 1.

Outcomes by programmatic element.

Outcome Early intervention Individualized and person-centered approaches Triadic involvement in collaborative care planning Multicomponent interventions Direct caregiver resources and tools Community building and social engagement
Psychological
 Distressa – –
 Emotional disruptiona –
 Well-being + (CG) + (Both) + (CG) + (Both)

  • + (CR)

  • 0 (CG)
 Subjective mood + (Both) + (Both) + (Both)
 Satisfaction with life and/or circumstances + (Both)

  • + (CR)

  • 0 (CG)

  • + (CR)

  • 0 (CG)
 Happiness + (Both)
 Stress and burdena 0 0 0 0
 Anxiety 0 (CG) − (CG) − (CG) 0 (CG) − (CR)
 Competence, mastery, and self-efficacya + + +
 Cognitive functioningb + +
 Depression symptomsa 0 – 0 0 0
Social/interpersonal
 Relationship between caregivers and persons living with dementia + (Both) + (Both) + (Both)
 Family conflicta – –
 Satisfaction with supporta + +
 Empathya + +
 Perspective-takinga + +
 Attitudes toward dementiaa +
 Social, emotional, and instrumental support + (Both) + (CG) + (Both) + (Both)
 Social engagement + (Both) + (CR) + (Both) + (CR)
Health, quality of life, and service use
 Aging in placeb +
 Quality of life + (Both) + (Both) + (Both)

  • + (CR)

  • 0 (CG)

 + (Both)

  • + (CG)

  • 0 (CR)
 Service use + (CR) + (CR) + (CR)

  • + (CR)

  • 0 (CG)
 Institutionalizationb – –
 Hospitalizationb – – – – –
 Emergency department visitsb – – – – –
 General functioningb 0 + 0 0 + +
 Knowledge of resourcesa +
 Knowledge of diseasea 0
 Satisfaction with intervention and quality of carec + (Both) + (Both) + (CR) + (Both)
Open in a new tab

Note. CG = caregiver; CR = care recipient (i.e., people living with dementia). To compute each cell, the positive, negative, and null effects observed across all studies exhibiting a given programmatic factor and measuring a given outcome were summed: + = more evidence to suggest a positive effect; − = more evidence to suggest a negative effect; and 0 = evidence is inconclusive.

a

Outcome applies to caregivers only.

b

Outcome applies to persons living with dementia only.

c

Encapsulates the following outcome variables: “satisfaction with pain control,” “satisfaction with end-of-life care,” “satisfaction with intervention,” “satisfaction with quality of care,” and “satisfaction with nursing care.”

Early intervention

Early identification, education, and timely connection to resources enable proactive care planning and management, empowering persons living with dementia and care partners to more readily navigate systems as well as support symptom management across the progression of dementia, including pain (Draper et al., 2018; Mets et al., 2013; MINT Memory Clinic, 2023). However, resource lists alone were found to be insufficient; ongoing assessment and tailored supports and navigation to these supports are essential throughout the dementia journey (Dahlrup et al., 2014). Early intervention also strengthens care partners’ coping strategies, reducing stress, burden, and guilt while improving well-being and quality of life (Dahlrup et al., 2014; Mohide et al., 1990).

Interventions that integrated early intervention showed improved care partner outcomes, enhanced service use, and supported aging in place (Dahlrup et al., 2014; Mets et al., 2013). Some evidence also suggests associations with lower rates of institutionalization, hospitalization, and emergency department visits for individuals living with dementia (Mohide et al., 1990; Shega et al., 2003).

Triadic involvement in collaborative health and social care planning

Triadic involvement in care planning has been shown to improve care partner satisfaction (Fauth et al., 2017), enhanced quality of life for individuals living with dementia and care partners (Mets et al., 2013; Whitlatch et al., 2019), reductions in family conflict (Fauth et al., 2017), and avoidance of premature or unnecessary institutionalization and hospitalization (Draper et al., 2018).

Care planning is essential for individuals living with dementia at all disease stages, with the most effective plans addressing evolving health and social care needs (Mets et al., 2013). While caregiving is often considered a dyadic process, care plans (including advance care planning) must instead be considered a collaborative triadic process involving the care recipient, care partner, and health providers (Draper et al., 2018; Mets et al., 2013; Shega et al., 2003). Triadic involvement also supports the development of care plans that reflect the preferences, social location (e.g., sociodemographics, context, and culture), and needs of both parties (Caprioli et al., 2023; Fauth et al., 2017; Whitlatch et al., 2019), including end-of-life wishes (Shega et al., 2003).

Individualized and person-centered approaches

Co-designing and tailoring interventions with individuals living with dementia and care partners will support interventions to meet the unique needs and preferences of those intended to benefit from them (Caprioli et al., 2023). Tailoring interventions include adjusting for care partners’ varying levels of dementia knowledge, care experience, system navigation skills, and capacity (Egan et al., 2018); offering a range of activities appropriate to different stages of cognitive functioning and abilities (Rokstad et al., 2019); and ensuring cultural sensitivity and attention to socio-demographics and geographical location (Caprioli et al., 2023; Draper et al., 2018; Ye et al., 2025). Person-centered approaches supported by interdisciplinary communication and engagement promote responsiveness and individualized care (Gan et al., 2024).

Positive outcomes of person-centered approaches include improved empathy (Au et al., 2023; Egan et al., 2018), well-being (Sin et al., 2018), social connection (Caprioli et al., 2023; Fauth et al., 2017; Tamplin et al., 2018), satisfaction with service, self-efficacy (Ye et al., 2025), and reduced anxiety among care partners (Egan et al., 2018). Some studies suggest potential benefits for cognitive functioning (Rokstad et al., 2019; Ye et al., 2025), behavioral and psychiatric symptoms (Ye et al., 2025), and hospital visits among care recipients (Draper et al., 2018), as well as increased service use among both (Whitlatch et al., 2019).

Multicomponent interventions

To meet the complex, evolving needs of individuals living with dementia and care partners, interventions may want to consider including: psychoeducation, social support, and access to health care professionals (Boyt et al., 2022). Pharmacological treatments (Mets et al., 2013) and addressing sensory impairments, such as hearing and vision changes, have demonstrated enhanced communication and social engagement (Leroi et al., 2020). Comprehensive multicomponent approaches were seen to integrate the built environment, psychosocial and health care supports, and care partner resources, emphasizing team-based collaboration (Draper et al., 2018; Gan et al., 2024).

eHealth interventions combining psychoeducation and counseling have demonstrated improved access to care (Sin et al., 2018), and another study noted care partner training in digital tools as essential (Caprioli et al., 2023). Integrating acute care with long-term services further supports aging-in-place (Draper et al., 2018).

Multicomponent interventions positively impact care partner well-being, self-efficacy, and social and emotional support (Sin et al., 2018), and, for individuals living with dementia, improve social engagement, quality of life, service use, and satisfaction with care (Leroi et al., 2020; Mets et al., 2013; Shega et al., 2003). These approaches, including integrating acute care with long-term services, demonstrated a reduction in avoidable institutionalization and hospitalization (Draper et al., 2018) and care partner distress (Boyt et al., 2022).

Direct care partner resources and tools

Multi-layered systems of direct support, training, and care environments work together to equip, assist, and reduce burden for care partners of individuals living with dementia. Programs like adult day services can reduce care partner burden, yet their effectiveness largely depends on flexibility (e.g., varied hours), accessibility (e.g., transportation options), and alignment with dementia stage (Lewis et al., 2015; Mohide et al., 1990; Rokstad et al., 2019). Care for individuals living with dementia should focus on consistency, work to reduce staff turnover, and create environments where care partners do not always have to repeat key care details (Mohide et al., 1990). Stable care teams in Assisted Living, Supportive Housing, and Adult Day Programs support continuity and quality care (Morton-Chang et al., 2019).

Care partner-focused strategies, such as skills training, goal-setting for respite, communication tools, managing responsive behaviors, and perspective-taking, can reduce stress and frustration (Au et al., 2023; Godfrey et al., 2025; Kashimura et al., 2021; Liddle et al., 2012). Accessible psychosocial support in care settings and telehealth tools are especially helpful for care partners during transitions or in rural areas where adult day programs or other forms of respite may not be as readily available (Caprioli et al., 2023; Draper et al., 2018; Greenwood et al., 2016; Sin et al., 2018; Ye et al., 2025). Additionally, telehealth options promote engagement with needed specialists and reduce travel burden (Ye et al., 2025).

Equipping the health and social care workforce with dementia-specific education, encouraging cross-sector collaboration, and including lived experience can improve practice and ensure people receive the right care at the right time (Gutmanis et al., 2015; Newman & White, 2016).

This programmatic factor had positive impacts for care partners (e.g., empathy, knowledge of resources, satisfaction with respite, relationships with staff) (Au et al., 2023; Boyt et al., 2022; Godfrey et al., 2025; Greenwood et al., 2016; Hattink et al., 2015; Kashimura et al., 2021; Lewis et al., 2015; Sin et al., 2018) and for care recipients (e.g., general functioning, service use, life satisfaction) (Caprioli et al., 2023; Dahlrup et al., 2014; Draper et al., 2018). For both, it was shown to improve quality of life, social support, and the care partner–care recipient relationship (Rokstad et al., 2019; Ye et al., 2025), while reducing care partner guilt and distress, as well as hospitalizations and institutionalization (Mohide et al., 1990).

Community building and social engagement

Interventions need to create consistent and purposeful opportunities for individuals with dementia and their care partners to build friendships and community, both in person and online (Rokstad et al., 2019; Sin et al., 2018). Creative, relational activities like attending art galleries, music circles, personalized playlists, and singing groups reduce stress and strengthen bonds (Camic et al., 2014; Hanser et al., 2011; Tamplin et al., 2018). Dementia-friendly design and staff training (Gan et al., 2024) were demonstrated to support accessibility, acceptance, and participation in community life.

These efforts have contributed to improved quality of life, emotional support, mood, and daily functioning for both care partners (Sin et al., 2018) and individuals living with dementia (Camic et al., 2014; Rokstad et al., 2019), while also comforting both care recipient and care partner (Hanser et al., 2011); lowering anxiety; and enhancing care partners’ ability to build new supportive relationships (Tamplin et al., 2018).

Design and implementation considerations

Through our review, we identified six considerations that contribute to effective design and implementation of community-based interventions. These include: (a) successful implementation of a program involves focusing on the target population; (b) delivery; (c) co-design and engagement strategies; (d) resources and system incentives; (e) geography and local context; and (f) impacts and outcomes. Together, these considerations offer a foundation for developing sustainable, person-centered community-based innovations.

Target population

Defining a target population is a key design consideration that ensures an intervention is appropriately tailored to meet the specific needs, identities, and circumstances of the individuals it is intended to support. Persons living with dementia are not a homogenous group. Effective programs consider the diverse needs of individuals living with dementia and their care partners, adapting to dementia stage, culture, and language (Dahlrup et al., 2014; Forward with dementia, 2022; Greenwood et al., 2016; Leroi et al., 2020). Tailored interventions, like psychosocial and educational supports, enhance comfort, promote goal-setting, and reduce burnout, supporting evolving care needs and informed decision-making over time.

Delivery

Carefully planning the methods, settings, and formats through which an intervention is delivered is essential for ensuring accessibility, engagement, and effectiveness. Tech-based supports can enhance access but require training, devices, reliable internet, and flexibility via computer versus telephone (Au et al., 2023; Boyt et al., 2022; Egan et al., 2018; Hanser et al., 2011; Hattink et al., 2015; Lewis et al., 2015; Liddle et al., 2012; Rokstad et al., 2019; Shega et al., 2003; Sin et al., 2018; Ye et al., 2025). Hybrid formats and 24/7 access help overcome barriers, boost confidence, and support evolving care needs across dementia stages.

Co-design and engagement

Actively involving individuals living with dementia and their care partners in shaping programs helps ensure interventions are grounded in the lived experience and foster sustained engagement over time. Interventions that are co-designed ensure relevance and reduce stigma (Lord et al., 2022; Mets et al., 2013; Public Health Agency of Canada, 2019; Sin et al., 2018; World Health Organization, 2017a). Co-design is strengthened by diverse participation, open and accessible communication, and reflection (University of Waterloo, n.d.). Assisting with the creation and review of goals can increase care partner satisfaction with respite (Godfrey et al., 2025). Regular check-ins (Mets et al., 2013; Shega et al., 2003; Sin et al., 2018) and practical supports like transportation (Rokstad et al., 2019; Tamplin et al., 2018) can enhance access to community interventions. Community-based, culturally inclusive initiatives, such as museum or gallery programming, promote social inclusion and challenge stigma, including ageism and dementia-related discrimination (Camic et al., 2014; Kashimura et al., 2021). These efforts improve well-being, foster belonging, and encourage participation across diverse groups of care partners and people living with dementia.

Resources and system incentives

Considering the financial, organizational, and policy supports (e.g., funding, reimbursement mechanisms, and cross-sector partnerships) to enable the sustainability and integration of interventions. Interventions for individuals living with dementia and their care partners must consider costs, access, and enabling structures (funding and incentives for cross-sector partnerships). Online formats reduce expenses and improve flexibility (Au et al., 2023; Caprioli et al., 2023; Egan et al., 2018; Hattink et al., 2015; Rokstad et al., 2019), but equitable access to technology and capacity building to use it is essential. Successful integration requires systemic support, including collaboration across sectors and reimbursement strategies that incentivize service delivery (Draper et al., 2018; Mets et al., 2013). Person-centered programs that benefit both individuals and the broader system should be prioritized (Draper et al., 2018).

Impacts and outcomes

Considering measurable changes in health, well-being, and quality of life that an intervention aims to achieve, established prior to implementation. Measuring and evaluating intervention impacts ensures that the evolving needs of individuals living with dementia and their care partners are met. Personalized goal setting supports meaningful outcomes (Leroi et al., 2020), while increasing awareness of available resources enhances service utilization (Whitlatch et al., 2019). Tools such as the Kingston Caregiver Stress Scale (Kingston Scales Institute, n.d.), Dementia Observation Scale (Behavioral Supports Ontario, n.d.), and Dementia Care Mapping (Surr et al., 2020) help monitor care partner stress, cognitive changes, and quality of life. Incorporating impact narratives and co-designed outcomes promotes relevance and responsiveness across physical, emotional, and social domains (brainXchange, n.d.; Kingston Scales Institute, n.d.; Leroi et al., 2020; Surr et al., 2020).

Geography and local context

Consider factors such as the physical, cultural, and social environments where interventions are delivered, as these influence accessibility, relevance, and sustainability within diverse communities. Considering local context and partners when designing and implementing programs ensures that they are accessible and sustainable for the community. Geographic context, including urban, rural, remote, and northern communities, poses distinct challenges for scalability, accessibility, and equity. Rural and remote areas, especially, face limited access to health and social services and other concerns, including access to reliable internet for virtual offerings. As a result, care delivery efforts in these regions frequently center on strategies to address resource gaps and ensure equitable service delivery across diverse settings (Draper et al., 2018).

Core principles

Through an integrative synthesis of empirical findings and practice-based guidance, four cross-cutting principles were identified as essential for advancing dementia-inclusive communities. Most notably, anti-stigma, accessibility, equity and intersectionality, and sustainability were identified as critical to informing how the programmatic factors and design considerations should be interpreted and implemented (see Figure 1). These principles also align with broader healthy aging and aging-in-place frameworks, including the World Health Organization’s Decade of Healthy Aging (2021), which emphasizes equity, inclusion, accessibility, and person-centered care.

Stigma remains a critical barrier to timely diagnosis and engagement, often exacerbated by negative public perceptions around cognitive impairment and harmful language. Anti-stigma efforts, including culturally appropriate terminology and proactive education, can foster dementia-inclusive communities and reduce isolation. Accessibility must consider structural and perceptual barriers, guided by various dimensions of access. We adopt the five dimensions of access (approachability, acceptability, availability, affordability, and appropriateness) described by Levesque and colleagues (Levesque et al., 2013).

Equity and intersectionality demand attention to how overlapping identities, such as race, gender, language, and geography, influence access to care and quality of support (Crenshaw, 1991). Lastly, sustainability remains a systemic challenge, with many pilot programs lacking predictable funding despite demonstrated impact. Ensuring long-term investments, co-design with lived experience experts, and coordinated cross-sector support is essential to advance scalable, enduring innovations for individuals living with dementia and their care partners.

These four principles help situate the findings within the broader context of health equity and inclusion, providing the scaffolding that situates programmatic factors and design considerations within an overarching vision for effective, sustainable, and inclusive dementia supports. These principles are also consistent with broader aging-in-place goals (Ball, 2005), which emphasize supporting autonomy, social participation, and equitable access to care within community settings. Each principle contributes to advancing aging in place in distinct yet complementary ways. Anti-stigma efforts reduce barriers to timely diagnosis and care engagement, supporting earlier intervention and sustained access to supports that enable individuals living with dementia to remain in their communities. Accessibility ensures that services are affordable, approachable, acceptable, and responsive to diverse needs, facilitating meaningful, individualized, and ongoing engagement with community-based supports. Equity and intersectionality emphasize the importance of tailoring care to diverse social locations, helping ensure that individuals receive appropriate and high-quality support. Finally, sustainability highlights the need for stable funding, cross-sector coordination, and long-term investment to maintain and scale community-based innovations that support aging in place.

Discussion and implications

This work presents a Principles to Practice Framework (Figure 1), which takes into account the complex, multidimensional nature of supporting individuals living with dementia and their care partners in community settings. It highlights key implementation considerations, programmatic success factors, common challenges, and promising directions for dementia-inclusive health and social systems, interpreted through the lens of the four core principles. Despite variations in delivery models and geographic contexts, most interventions consistently embedded at least two of the six programmatic factors identified in our framework (i.e., early intervention, triadic collaborative care planning, individualized and person-centered approaches, multicomponent supports, direct care partner resources, and community building and social engagement). These were reinforced by six cross-cutting implementation considerations (target population, delivery format, co-design, geography, funding, and outcome measurement) and were grounded in four core principles: anti-stigma, accessibility, equity and intersectionality, and sustainability (Brown, 2016; Warrik et al., 2018). These framework elements aim to counteract the siloed and fragmented nature of service landscapes commonly reported in high-income contexts such as the US, UK, Canada, and Australia, while acknowledging that the extent and nature of fragmentation, coordination mechanisms, and available supports differ substantially across jurisdictions.

Many community-based initiatives are led by not-for-profit organizations and Non-Government Organizations (NGOs), often relying on patchwork or time-limited funding (Alzheimer’s Association, 2025; Horstman et al., 2023; Institute for Accountable Care, 2022; Peckham et al., 2018). However, the structure of funding and commissioning for dementia-related supports varies considerably between countries, even among those with otherwise similar health and social care systems. For example, countries with nationalized systems (like the UK) face different constraints and opportunities than more market-driven or decentralized systems (like the US and Canada). Reducing intervention costs and introducing system-level incentives, such as baseline funding that redirects resources from institutional care to community-based programs, can improve access to essential services and foster more sustainable and scalable models of care (Caprioli et al., 2023; Draper et al., 2018; Hattink et al., 2015; Mets et al., 2013). In considering the best options for support, scope, and reach, it is important to achieve a balance between cost efficiencies, economies of scale, and opportunities for social inclusion and individually tailored interventions. For example, while group-based interventions can promote peer connection and reduce isolation, they may not adequately meet the unique and varied needs of all care partners, underscoring the value of individualized, person-centered approaches (Dahlrup et al., 2014; Fauth et al., 2017; Greenwood et al., 2016; Leroi et al., 2020; Mohide et al., 1990).

From a policy perspective, funding structures should support flexible, long-term investments that not only enable the development of innovations but also promote the combination and scaling of existing services. Public-private partnerships (PPPs) represent one potential strategy to address structural gaps in community-based dementia care, though their effectiveness varies across health system contexts. For instance, PPPs have been used to strengthen infrastructure and service delivery in countries such as Australia and Canada, whereas in the US they often emerge in more fragmented or market-oriented environments with different risk-sharing arrangements (Sekhri et al., 2011). These partnerships, when developed through co-design with communities and guided by equity and sustainability principles, can serve as a foundation for the multicomponent, person-centered supports identified in our framework. They also provide an opportunity to embed critical implementation considerations, including sustained funding, system-level incentives, attention to local context, co-design, and community engagement (Baru & Nundy, 2008; Torchia et al., 2015). Evaluative efforts that include holistic socio-economic impact considerations are essential to understand the effectiveness of these partnerships and interventions, including more individualized measures such as personalized goal-setting. These findings should be interpreted as identifying patterns across community-based supports rather than establishing direct comparisons. When designed effectively, these collaborations can reduce duplication, streamline service delivery, and avoid adding complexity to already fragmented social care systems. Without such integrated, context-responsive approaches, service gaps are likely to persist, placing additional strain on care systems and families while hindering progress toward sustainable, dementia-inclusive communities.

At the practice level, fostering greater collaboration between health systems, community organizations, care partners, and individuals living with dementia themselves is essential to ensuring that interventions are tailored and responsive to the complex and intersectional needs of individuals living with dementia (Innes et al., 2024). The emphasis on anti-stigma, equity, and accessibility further reinforces the need for inclusive, culturally sensitive practices that reach diverse caregiving populations (Logan & Castañeda, 2020). Ultimately, these findings call for a shift toward a more holistic, integrated system of care that extends beyond traditional health services and responds to local context, ensuring that care partners and individuals living with dementia receive the ongoing, individualized support they require to maintain independence in the community.

While this review offers robust insights to support the design and implementation of community-based dementia innovations, several limitations should be acknowledged. Our search was limited in its scope, restricted to four databases, used specific search terms, focused exclusively on dementia without addressing other common comorbidities, and included only peer-reviewed literature published in English and conducted in high-income countries with relatively homogenous and majority-White samples. These may limit the breadth of literature across key disciplines, restrict the comprehensiveness of our findings, and potentially overlook relevant cultural, geographic, and funding contexts. Using broad community-based care search terms rather than program-specific labels (e.g., respite, day programs, green care farms, and meeting centers) may have inadvertently limited some jurisdiction-specific or specialized interventions. Although studies were not systematically screened for quality, we did document the strength of results and any potential methodological biases. As this analysis was based on cross-study thematic synthesis rather than direct comparison or meta-analysis, these findings should be interpreted as identifying patterns and promising practices. Finally, we engaged key informants (a care partner for a person living with dementia, an individual living with cognitive decline, a caregiving-focused researcher, and a dementia-focused organization representative) to complement the literature and validate the material. Despite these limitations, the framework offers a valuable foundation that will be further tested and refined in our future research (i.e., jurisdictional review) to map existing supports, identify gaps, and inform future investment and service design.

The principles form the foundation of dementia-inclusive approaches that are both just and effective. Building on these principles, the six programmatic factors identified highlight critical elements for shaping meaningful and responsive support. In turn, the design and implementation considerations offer actionable guidance to tailor interventions. Ultimately, this framework offers a strategic lens to assess the alignment of existing community-based dementia supports with evidence-informed principles and factors, while also identifying gaps in availability, design, or implementation that can guide future innovations.

Supplementary Material

igag094_Supplementary_Data
igag094_supplementary_data.docx (60.1KB, docx)

Acknowledgments

We are grateful to experts in Canada for their review and feedback on earlier versions of our report, including Dr. Saskia Sivananthan, Phyllis Fehr, Ron Beleno, and Dr. Sharon Anderson, as well as Rebecca Chau, Kayla Monsey, and Chantal Skon, research assistants who supported data collection and extraction efforts.

Contributor Information

Allie Peckham, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, United States; Center for Innovation in Healthy and Resilient Aging, Arizona State University, Phoenix, Arizona, United States.

Monika Roerig, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Sage Sadow, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, United States.

Frances Morton-Chang, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Laura Schmid, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, United States.

Clare Schuchardt, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, United States.

Molly Budhiraja, College of Life Sciences, Arizona State University, Tempe, Arizona, United States.

Sara Allin, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Supplementary material

Supplementary material is available at Innovation in Aging online.

Funding

This work was supported by the Rossy Foundation.

Conflicts of interest

None declared.

Data availability

Data can be found in the Supplementary Material. The RIS files are available upon request. Six out of 25 of the manuscripts included were preregistered. This study has been registered with the Open Scientific Framework: https://osf.io/trxgk/

References

  1. Agonafer E. P., Carson S. L., Nunez V., Poole K., Hong C. S., Morales M., Jara J., Hakopian S., Kenison T., Bhalla I., Cameron F., Vassar S. D., Brown A. F. (2021). Community-based organizations’ perspectives on improving health and social service integration. BMC Public Health, 21, 452. 10.1186/s12889-021-10449-w [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Alzheimer’s Association. (2025). Alzheimer’s disease facts and figures.  https://www.alz.org/getmedia/ef8f48f9-ad36-48ea-87f9-b74034635c1e/alzheimers-facts-and-figures.pdf
  3. Alzheimer’s Disease International. (2024). World Alzheimer Report 2024: Global changes in attitudes to dementia.  https://www.alzint.org/resource/world-alzheimer-report-2024/
  4. Au A., Lai D. W. L., Chow A. Y. M., Lai S., Cheng S.-T. (2023). Connecting through caregiving: Reappraising intergeneration relationship in dementia caregiving. Applied Research in Quality of Life, 18, 2441–2457. 10.1007/s11482-023-10193-w [DOI] [Google Scholar]
  5. Ayres L., Kavanaugh K., Knafl K. A. (2003). Within-case and across-case approaches to qualitative data analysis. Qualitative Health Research, 13, 871–883. 10.1177/1049732303013006008 [DOI] [PubMed] [Google Scholar]
  6. Ball M. S. (2005). Aging in place: A toolkit for local governments. Community Housing Resource Center. https://www.ca-ilg.org/sites/main/files/file-attachments/resources__aginginplace.pdf [Google Scholar]
  7. Baru R. V., Nundy M. (2008). Blurring of boundaries: Public-private partnerships in health services in India. Economic and Political Weekly, 43, 62–71. https://www.epw.in/journal/2008/04/special-articles/blurring-boundaries-public-private-partnerships-health-services [Google Scholar]
  8. Behavioral Supports Ontario. (n.d.). Behavioural Supports Ontario – Dementia Observation System (BSO-DOS©). brainXchange. https://brainxchange.ca/bsodos. Date accessed May 5, 2025.
  9. Blanken A., Dewulf G. (2010). PPPs in health: Static or dynamic?  Australian Journal of Public Administration, 69, S35–S47. 10.1111/j.1467-8500.2009.00656.x [DOI] [Google Scholar]
  10. Bouck Z., Straus S. E., Tricco A. C. (2022). Systematic versus rapid versus scoping reviews. In Evangelou E., Veroniki A. A. (Eds.), Meta-research: Methods and protocols (pp. 103–119). Springer US. 10.1007/978-1-0716-1566-9_6 [DOI] [PubMed] [Google Scholar]
  11. Boyt N., Ho A. K., Morris-Bankole H., Sin J. (2022). Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis. Digital Health, 8, 205520762211290. 10.1177/20552076221129069 [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. brainXchange. (n.d.). Behavioural Supports Ontario – Dementia Observation System (BSO-DOS©).  https://brainxchange.ca/bsodos. Date accessed March 28, 2025.
  13. Brown A. D. (2016). Smarter approaches to dementia. HealthcarePapers, 16, 4–6. 10.12927/hcpap.2017.25007 [DOI] [PubMed] [Google Scholar]
  14. Camic P. M., Tischler V., Pearman C. H. (2014). Viewing and making art together: A multi-session art-gallery-based intervention for people with dementia and their carers. Aging & Mental Health, 18, 161–168. 10.1080/13607863.2013.818101 [DOI] [PubMed] [Google Scholar]
  15. Caprioli T., Mason S., Tetlow H., Reilly S., Giebel C. (2023). Exploring the views and the use of information and communication technologies to access post-diagnostic support by people living with dementia and unpaid carers: A systematic review. Aging & Mental Health, 27, 2329–2345. 10.1080/13607863.2023.2196246 [DOI] [PubMed] [Google Scholar]
  16. Co M., Couch E., Gao Q., Mac‐Ginty S., Das‐Munshi J., Prina M. (2021). Access to health services in older minority ethnic groups with dementia: A systematic review. Journal of the American Geriatrics Society, 69, 822–834. 10.1111/jgs.16929 [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Corry M., Neenan K., Brabyn S., Sheaf G., Smith V. (2019). Telephone interventions, delivered by healthcare professionals, for providing education and psychosocial support for informal caregivers of adults with diagnosed illnesses. The Cochrane Database of Systematic Reviews, 5, CD012533. 10.1002/14651858.CD012533.pub2 [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Crance S. J., Yu F. (2025). Characteristics, needs, and perspectives of individuals living alone with dementia: An integrative review. Health Science Reports, 8, e70348. 10.1002/hsr2.70348 [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Crenshaw K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43, 1241–1299. 10.2307/1229039 [DOI] [Google Scholar]
  20. Dahlrup B., Nordell E., Steen Carlsson K., Elmståhl S. (2014). Health economic analysis on a psychosocial intervention for family caregivers of persons with dementia. Dementia and Geriatric Cognitive Disorders, 37, 181–195. 10.1159/000355365 [DOI] [PubMed] [Google Scholar]
  21. Davis J. D., Tremont G., Bishop D. S., Fortinsky R. H. (2011). A telephone-delivered psychosocial intervention improves dementia caregiver adjustment following nursing home placement. International Journal of Geriatric Psychiatry, 26, 380–387. 10.1002/gps.2537 [DOI] [PubMed] [Google Scholar]
  22. Dobbins M. (2017). Rapid Review Guidebook.  Hamilton, ON: National Collaborating Centre for Methods and Tools. https://www.nccmt.ca/tools/rapid-review-guidebook [Google Scholar]
  23. Draper B., Low L.-F., Brodaty H. (2018). Integrated care for adults with dementia and other cognitive disorders. International Review of Psychiatry, 30, 272–291. 10.1080/09540261.2018.1564021 [DOI] [PubMed] [Google Scholar]
  24. Egan K. J., Pinto-Bruno Á. C., Bighelli I., Berg-Weger M., Van Straten A., Albanese E., Pot A.-M. (2018). Online training and support programs designed to improve mental health and reduce burden among caregivers of people with dementia: A systematic review. Journal of the American Medical Directors Association, 19, P200–P206.e1. 10.1016/j.jamda.2017.10.023 [DOI] [PubMed] [Google Scholar]
  25. Fauth E. B., Jackson M. A., Walberg D. K., Lee N. E., Easom L. R., Alston G., Ramos A., Felten K., LaRue A., Mittelman M. (2017). External validity of the New York University Caregiver Intervention: Key caregiver outcomes across multiple demonstration projects. Journal of Applied Gerontology, 38, 1253–1281. 10.1177/0733464817714564 [DOI] [PubMed] [Google Scholar]
  26. Forward with dementia. (2022). 4.5 Make time for your own health.  https://forwardwithdementia.ca/article/4-5-make-time-for-your-own-health/
  27. Gan D. R. Y., Mann J., Chaudhury H. (2024). Dementia care and prevention in community settings: A built environment framework for cognitive health promotion. Current Opinion in Psychiatry, 37, 107–122. 10.1097/YCO.0000000000000917 [DOI] [PubMed] [Google Scholar]
  28. Godfrey D. A., Wong B., Thompson A. D., Coleman M. E., Sparks C., Utz R. L. (2025). Respite time-use among dementia caregivers. Frontiers in Health Services, 5 Article 1598518. 10.3389/frhs.2025.1598518 [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Government of Canada. (2024, August 27). Thinking about aging in place.  https://www.canada.ca/en/employment-social-development/corporate/seniors-forum-federal-provincial-territorial/aging.html
  30. Greenwood N., Pelone F., Hassenkamp A.-M. (2016). General practice-based psychosocial interventions for supporting carers of people with dementia or stroke: A systematic review. BMC Family Practice, 17, 3. 10.1186/s12875-015-0399-2 [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Gutmanis I., Snyder M., Harvey D., Hillier L. M., LeClair J. K. (2015). Health care redesign for responsive behaviors—The Behavioral Supports Ontario Experience: Lessons learned and keys to success. Canadian Journal of Community Mental Health, 34, 45–63. 10.7870/cjcmh-2015-001 [DOI] [Google Scholar]
  32. Hanser S. B., Butterfield-Whitcomb J., Kawata M., Collins B. E. (2011). Home-based music strategies with individuals who have dementia and their family caregivers. Journal of Music Therapy, 48, 2–27. 10.1093/jmt/48.1.2 [DOI] [PubMed] [Google Scholar]
  33. Hattink B., Meiland F., Van Der Roest H., Kevern P., Abiuso F., Bengtsson J., Giuliano A., Duca A., Sanders J., Basnett F., Nugent C., Kingston P., Dröes R.-M. (2015). Web-based STAR e-learning course increases empathy and understanding in dementia caregivers: Results from a randomized controlled trial in the Netherlands and the United Kingdom. Journal of Medical Internet Research, 17, e241. 10.2196/jmir.4025 [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Head B. W., Alford J. (2015). Wicked problems: Implications for public policy and management. Administration & Society, 47, 711–739. 10.1177/0095399713481601 [DOI] [Google Scholar]
  35. Horstman C., Gumas E., Jacobson G. (2023, February 16). U.S. and Global Approaches to Financing Long-Term Care: Understanding the Patchwork.  The Commonwealth Fund. 10.26099/2m36-vt53 [DOI] [Google Scholar]
  36. Innes A., O’Connell M. E., Geoghegan C., Fehr P. (2024). How to live well with dementia: Expert help for people living with dementia and their family, friends, and care partners. Routledge. 10.4324/9781003457138 [DOI] [Google Scholar]
  37. Institute for Accountable Care. (2022). Establishing sustainable partnerships with community-based organizations: Considerations for ACOs.  http://www.institute4ac.org/wp-content/uploads/2022/09/Brief-5_Establishing-ACO-Partnerships-with-CBOs.V6_LH.pdf
  38. Jenkins E. K., Slemon A., Haines-Saah R. J., Oliffe J. (2018). A guide to multisite qualitative analysis. Qualitative Health Research, 28, 1969–1977. 10.1177/1049732318786703 [DOI] [PubMed] [Google Scholar]
  39. Jones B. W. (2013). Critically appraised topic: The effect of hospice care in patients with dementia. American Journal of Hospice and Palliative Medicine, 30, 821–830. 10.1177/1049909112457705 [DOI] [PubMed] [Google Scholar]
  40. Kashimura M., Rapaport P., Nomura T., Ishiwata A., Tateno A., Nogami A., Yamashita M., Kawanishi T., Kawashima Y., Kitamura S., Livingston G. (2021). Acceptability and feasibility of a Japanese version of STrAtegies for RelaTives (START-J): A manualized coping strategy program for family caregivers of relatives living with dementia. Dementia, 20, 985–1004. 10.1177/1471301220919938 [DOI] [PubMed] [Google Scholar]
  41. Kaufman B. G., Huang R. W., Holland D. E., Vanderboom C. E., Ingram C., Wild E. M., Dose A. M., Stiles C., Gustavson A. M., Mandrekar J., Van Houtven C. H., Griffin J. M. (2024). Healthcare use and out‐of‐pocket costs for rural family caregivers and care recipients in a randomized controlled trial. Journal of the American Geriatrics Society, 72, 2523–2531. 10.1111/jgs.18934 [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Kingston Scales Institute. (n.d.). Caregiver Stress Scale. Kingston Scales. http://www.kingstonscales.org/caregiver-stress-scale.html
  43. Leong C. A., Summers A., Grote V., Jackson K., Dowling G., Snowberg K., Cotten P., Cheung E., Yang D., Addington E. L., Moskowitz J. T. (2024). Randomized controlled trial of a positive emotion regulation intervention to reduce stress in family caregivers of individuals with Alzheimer’s disease: Protocol and design for the LEAF 2.0 study. BMC Geriatrics, 24, 289. 10.1186/s12877-024-04817-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Leroi I., Simkin Z., Hooper E., Wolski L., Abrams H., Armitage C. J., Camacho E., Charalambous A. P., Collin F., Constantinidou F., Dawes P., Elliott R., Falkingham S., Frison E., Hann M., Helmer C., Himmelsbach I., Hussain H., Marié S., Yeung W. K. (2020). Impact of an intervention to support hearing and vision in dementia: The SENSE‐Cog Field Trial. International Journal of Geriatric Psychiatry, 35, 348–357. 10.1002/gps.5231 [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Levesque J.-F., Harris M. F., Russell G. (2013). Patient-centered access to health care: Conceptualizing access at the interface of health systems and populations. International Journal for Equity in Health, 12, 18. 10.1186/1475-9276-12-18 [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Lewis V., Bauer M., Winbolt M., Chenco C., Hanley F. (2015). A study of the effectiveness of MP3 players to support family caregivers of people living with dementia at home. International Psychogeriatrics, 27, 471–479. 10.1017/S1041610214001999 [DOI] [PubMed] [Google Scholar]
  47. Liddle J., Smith-Conway E. R., Baker R., Angwin A. J., Gallois C., Copland D. A., Pachana N. A., Humphreys M. S., Byrne G. J., Chenery H. J. (2012). Memory and communication support strategies in dementia: Effect of a training program for informal caregivers. International Psychogeriatrics, 24, 1927–1942. 10.1017/S1041610212001366 [DOI] [PubMed] [Google Scholar]
  48. Liu K. Y., Howard R., Banerjee S., Comas-Herrera A., Goddard J., Knapp M., Livingston G., Manthorpe J., O’Brien J. T., Paterson R. W., Robinson L., Rossor M., Rowe J. B., Sharp D. J., Sommerlad A., Suárez-González A., Burns A. (2021). Dementia well-being and COVID-19: Review and expert consensus on current research and knowledge gaps. International Journal of Geriatric Psychiatry, 36, 1597–1639. 10.1002/gps.5567 [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Logan R. I., Castañeda H. (2020). Addressing health disparities in the rural United States: Advocacy as caregiving among community health workers and promotores de salud. International Journal of Environmental Research and Public Health, 17, 9223. 10.3390/ijerph17249223 [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Lord K., Kelleher D., Ogden M., Mason C., Rapaport P., Burton A., Leverton M., Downs M., Souris H., Jackson J., Lang I., Manthorpe J., Cooper C. (2022). Co-designing complex interventions with people living with dementia and their supporters. Dementia, 21, 426–441. 10.1177/14713012211042466 [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Mason R. O., Mitroff I. I. (1981). Challenging strategic planning assumptions: Theory, cases, and techniques. Wiley. [Google Scholar]
  52. McCleary L., Persaud M., Hum S., Pimlott N. J., Cohen C. A., Koehn S., Leung K. K., Dalziel W. B., Kozak J., Emerson V. F., Silvius J. L., Garcia L., Drummond N. (2013). Pathways to dementia diagnosis among South Asian Canadians. Dementia, 12, 769–789. 10.1177/1471301212444806 [DOI] [PubMed] [Google Scholar]
  53. Melin Emilsson U., Strid A.-L., Söderberg M. (2022). Lack of coordination between health care and social care in multiprofessional teamwork—The obstacle for coherent care of older people suffering from multimorbidity. Journal of Population Ageing, 15, 319–335. 10.1007/s12062-020-09300-8 [DOI] [Google Scholar]
  54. Mets T., De Deyn P. P., Pals P., De Lepeleire J., Vandewoude M., Ventura M., Ivanoiu A., Albert A., Seghers A.-K. (2013). COGNOS: Care for people with cognitive dysfunction: A national observational study. Alzheimer Disease & Associated Disorders, 27, 123–132. 10.1097/wad.0b013e318256d1d0 [DOI] [PubMed] [Google Scholar]
  55. MINT Memory Clinic. (2023). About MINT Memory Clinic. MINT Memory Clinic. https://mintmemory.ca/about
  56. Mohide E. A., Pringle D. M., Streiner D. L., Gilbert J. R., Muir G., Tew M. (1990). A randomized trial of family caregiver support in the home management of dementia. Journal of the American Geriatrics Society, 38, 446–454. 10.1111/j.1532-5415.1990.tb03544.x [DOI] [PubMed] [Google Scholar]
  57. Morton-Chang F., Williams A. P., Berta W., Laporte A. (2019). Towards a community-based dementia care strategy: How do we get there from here?  World Health & Population, 18, 6–29. 10.12927/whp.2019.26062 [DOI] [PubMed] [Google Scholar]
  58. Newman K., White F. (2016). Gerontological nursing and dementia care: Enhancing practice through collaboration and knowledge exchange. Perspective, 38, 21–23. [Google Scholar]
  59. Peckham A., Morton-Chang F., Williams A. P., Miller F. A. (2018). Rebalancing health systems toward community-based care: The role of subsectoral politics. Health Policy, 122, 1260–1265. 10.1016/j.healthpol.2018.09.014 [DOI] [PubMed] [Google Scholar]
  60. Peckham A., Sadow S., Schmid L., Roerig M., Budhiraja M., Chau R., Monsey K., Schuchardt-Vogt C., Skon C., Morton-Chang F., Allin S. (2025, October). NAO Rapid Review: Community-based supports for people living with Alzheimer’s disease and related dementias and care partners (Rapid Review No. 47). North American Observatory on Health Systems and Policies. https://naohealthobservatory.ca/research/community-based-supports-for-people-living-with-alzheimers-disease-and-related-dementias-and-care-partners/
  61. Peckham A., Saragosa M., King M., Roerig M., Shaw J., Bornstein S., McGrail K., Morris M., Young Y., Papenkov M. V., Marchildon G. (2022). Policy programs and service delivery models for older adults and their caregivers: Comparing three provinces and two states. Health & Social Care in the Community, 30, e4264–e4279. 10.1111/hsc.13820 [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Public Health Agency of Canada. (2019). A Dementia Strategy for Canada: Together We Aspire.  https://www.canada.ca/content/dam/phac-aspc/images/services/publications/diseases-conditions/dementia-strategy/National%20Dementia%20Strategy_ENG.pdf
  63. Rokstad A. M. M., McCabe L., Robertson J. M., Strandenæs M. G., Tretteteig S., Vatne S. (2019). Day Care for people with dementia: A qualitative study comparing experiences from Norway and Scotland. Dementia, 18, 1393–1409. 10.1177/1471301217712796 [DOI] [PubMed] [Google Scholar]
  64. Sekhri N., Feachem R., Ni A. (2011). Public-private integrated partnerships demonstrate the potential to improve health care access, quality, and efficiency. Health Affairs, 30, 1498–1507. 10.1377/hlthaff.2010.0461 [DOI] [PubMed] [Google Scholar]
  65. Shega J., Levin A., Hougham G., Cox-Hayley D., Luchins D., Hanrahan P., Stocking C., Sachs G. (2003). Palliative Excellence in Alzheimer Care Efforts (PEACE): A program description. Journal of Palliative Medicine, 6, 315–320. 10.1089/109662103764978641 [DOI] [PubMed] [Google Scholar]
  66. Sin J., Henderson C., Spain D., Cornelius V., Chen T., Gillard S. (2018). eHealth interventions for family carers of people with long-term illness: A promising approach?  Clinical Psychology Review, 60, 109–125. 10.1016/j.cpr.2018.01.008 [DOI] [PubMed] [Google Scholar]
  67. Surr C. A., Holloway I., Walwyn R. E., Griffiths A. W., Meads D., Kelley R., Martin A., McLellan V., Ballard C., Fossey J., Burnley N., Chenoweth L., Creese B., Downs M., Garrod L., Graham E. H., Lilley-Kelley A., McDermid J., Millard H., Farrin A. J. (2020). Dementia Care MappingTM to reduce agitation in care home residents with dementia: The EPIC cluster RCT. Health Technology Assessment, 24, 1–172. 10.3310/hta24160 [DOI] [PMC free article] [PubMed] [Google Scholar]
  68. Tamplin J., Clark I. N., Lee Y.-E. C., Baker F. A. (2018). Remini-Sing: A feasibility study of therapeutic group singing to support relationship quality and wellbeing for community-dwelling people living with dementia and their family caregivers. Frontiers in Medicine, 5, 245. 10.3389/fmed.2018.00245 [DOI] [PMC free article] [PubMed] [Google Scholar]
  69. Thomas J., Harden A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45. 10.1186/1471-2288-8-45 [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Torchia M., Calabrò A., Morner M. (2015). Public–Private Partnerships in the Health Care Sector: A systematic review of the literature. Public Management Review, 17, 236–261. 10.1080/14719037.2013.792380 [DOI] [Google Scholar]
  71. Tricco A. C., Antony J., Zarin W., Strifler L., Ghassemi M., Ivory J., Perrier L., Hutton B., Moher D., Straus S. E. (2015). A scoping review of rapid review methods. BMC Medicine, 13, 224. 10.1186/s12916-015-0465-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. U.S. Centers for Disease Control and Prevention. (2025, January 31). Caregivers of a person with Alzheimer’s disease or a related dementia. Caregiving. https://www.cdc.gov/caregiving/about/index.html
  73. University of Waterloo. (n.d.). Authentic partnerships | Partnerships in dementia care. https://uwaterloo.ca/partnerships-in-dementia-care/our-philosophy/authentic-partnerships
  74. USAging. (2024). Caregiver supports. https://www.usaging.org/caregivers
  75. Warrik N., Prorok J., Seitz D. (2018). Care of community-dwelling older adults with dementia and their caregivers. Canadian Medical Association Journal, 190, E794–E799. 10.1503/cmaj.170920 [DOI] [PMC free article] [PubMed] [Google Scholar]
  76. Watkins M., Overton L. (2024). The cost of caring: A scoping review of qualitative evidence on the financial wellbeing implications of unpaid care to older adults. Ageing & Society, 45, 1465–1492. 10.1017/S0144686X24000382 [DOI] [Google Scholar]
  77. Whitlatch C. J., Heid A. R., Femia E. E., Orsulic-Jeras S., Szabo S., Zarit S. H. (2019). The support, health, activities, resources, and education program for early-stage dementia: Results from a randomized controlled trial. Dementia, 18, 2122–2139. 10.1177/1471301217743033 [DOI] [PubMed] [Google Scholar]
  78. Wiles J. L., Leibing A., Guberman N., Reeve J., Allen R. E. S. (2012). The meaning of “aging in place” to older people. The Gerontologist, 52, 357–366. 10.1093/geront/gnr098 [DOI] [PubMed] [Google Scholar]
  79. World Health Organization. (2021). WHO’s Work on the UN Decade of Healthy Ageing (2021-2030). https://www.who.int/initiatives/decade-of-healthy-ageing. Date accessed September 14, 2026. [Google Scholar]
  80. World Health Organization. (2017a). Global action plan on the public health response to dementia 2017–2025.  https://apps.who.int/iris/handle/10665/259615
  81. World Health Organization. (2017b). Rapid reviews to strengthen health policy and systems: A practical guide.  https://ahpsr.who.int/publications/i/item/2017-08-10-rapid-reviews-to-strengthen-health-policy-and-systems-a-practical-guide
  82. Wu Y.-T., Clare L., Jones I. R., Martyr A., Nelis S. M., Quinn C., Victor C. R., Lamont R. A., Rippon I., Matthews F. E., & the Improving the experience of Dementia and Enhancing Active Life (IDEAL) study. (2018). Inequalities in living well with dementia-The impact of deprivation on well-being, quality of life, and life satisfaction: Results from the Improving the Experience of Dementia and Enhancing Active Life study. International Journal of Geriatric Psychiatry, 33, 1736–1742. 10.1002/gps.4998 [DOI] [PubMed] [Google Scholar]
  83. Ye M., Liu Z., Xie W., Shou M., Wang S., Lin X., Xu Y., Yao M., Chen J., Shou Y., Wu J., Guan L. (2025). Implementation of telemedicine for patients with dementia and their caregivers: Scoping review. Journal of Medical Internet Research, 27, e65667. 10.2196/65667 [DOI] [PMC free article] [PubMed] [Google Scholar]
  84. Yu D.-T., Li R.-X., Sun J.-R., Rong X.-W., Guo X.-G., Zhu G.-D. (2025). Global mortality, prevalence, and disability-adjusted life years of Alzheimer’s disease and other dementias in adults aged 60 years or older, and the impact of the COVID-19 pandemic: A comprehensive analysis for the global burden of disease 2021. BMC Psychiatry, 25, 503. 10.1186/s12888-025-06661-2 [DOI] [PMC free article] [PubMed] [Google Scholar]
  85. Zamani E. D., Sbaffi L., Kalua K. (2023). Addressing the information needs of informal carers in Malawi: A healthcare intervention based on co-creation. Journal of Documentation, 80, 131–157. 10.1108/JD-12-2022-0264 [DOI] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

igag094_Supplementary_Data
igag094_supplementary_data.docx (60.1KB, docx)

Data Availability Statement

Data can be found in the Supplementary Material. The RIS files are available upon request. Six out of 25 of the manuscripts included were preregistered. This study has been registered with the Open Scientific Framework: https://osf.io/trxgk/

Articles from Innovation in Aging are provided here courtesy of Oxford University Press

RESOURCES