Which model of Extra Care should we go for if we aim to cater for people with dementia?

Within Extra Care there are a number of different models for meeting the needs of people with dementia, typically classified as:

  • Integrated approach - the whole scheme is designed to be dementia-friendly and those with dementia are scattered through the scheme. In some developments, the ratio of those with dementia to those with other frailties at point of entry is pre-determined
  • Separate approach - A defined number of properties are clustered together specifically for people with dementia
  • Specialist or dedicated schemes - Targeted primarily or exclusively at people with dementia
  • Hybrid developments - Combine a number of different provisions on a single site, for example: dementia-friendly extra care with specialist nursing or residential care and a resource centre

Very little research has been done into the pros and cons of different models. The reality seems to be that each has advantages and disadvantages and can succeed or fail in supporting people with dementia to live well. Success will be depend on counteracting the downsides of the chosen model, and ensuring that all aspects of the development are properly tailored for the people it is targeting. For example, the podcast on Margery Girling House, Felixstow (opens new window), makes it clear that whilst the properties for people with dementia are clustered together, the services are delivered in an integrated way.

Slides 10 and 11 of the presentation "Extra Care Housing and dementia: Commissioning for quality - an overview of the issues (opens new window)" suggests possible pros and cons of different models.

Page 65 of the HDRC Literature review (opens new window) outlines some of the message from current evidence