14. Western Europe

  1. Hugo de Waal MD, FRCPsych, FHEA10,
  2. Constantine Lyketsos MD, MHS11,
  3. David Ames BA, MD, FRCPsych, FRANZCP12 and
  4. John O'Brien BA, BM BCh, MA, FRCPsych, MD13
  1. Siegfried Weyerer1,
  2. Raimundo Mateos2,
  3. Manuel Sánchez-Pérez3,
  4. Manuel Franco4,
  5. Lars-Olof Wahlund7,
  6. Stephen Curran8 and
  7. John Wattis9

Published Online: 7 JUL 2013

DOI: 10.1002/9781118378663.ch14

Designing and Delivering Dementia Services

Designing and Delivering Dementia Services

How to Cite

Weyerer, S., Mateos, R., Sánchez-Pérez, M., Franco, M., Wahlund, L.-O., Curran, S. and Wattis, J. (2013) Western Europe, in Designing and Delivering Dementia Services (eds H. de Waal, C. Lyketsos, D. Ames and J. O'Brien), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118378663.ch14

Editor Information

  1. 10

    Lead Consultant, Norfolk Dementia Care Academy, Norwich, UK

  2. 11

    Associate Postgraduate Dean, East of England Deanery, Cambridge, UK

  3. 12

    Elizabeth Plank Althouse Professor, Director of the Johns Hopkins Memory and Alzheimer's Treatment Center, Johns Hopkins Medicine, Maryland, USA

  4. 13

    Director, National Ageing Research Institute, University of Melbourne Professor of Ageing and Health, Victoria, Australia

Author Information

  1. 1

    Zentralinstitut für Seelische Gesundheit, Deutschland

  2. 2

    Department of Psychiatry, University of Santiago de Compostela, USC, Spain

  3. 3

    Psychogeriatric Unit, CHUS University Hospital, School of Medicine, Spain

  4. 4

    University of Salamanca, Spain

  5. 7

    Department of Neurobiology, Care Sciences and Society, Section of Clinical Geriatrics and Section of Nursing, Karolinska Institutet, Sweden

  6. 8

    South West Yorkshire Partnership NHS Foundation Trust, UK

  7. 9

    Centre for Health and Social Care Research, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK

Publication History

  1. Published Online: 7 JUL 2013

ISBN Information

Print ISBN: 9781119953494

Online ISBN: 9781118378663



  • Germany;
  • geriatric day care;
  • nursing home care;
  • segregated model;
  • partially segregated model;
  • Spain;
  • SNS;
  • Socio-Sanitario;
  • long term care;
  • National Strategy for the Care of Dementia


In Germany first contact is usually with a primary care physician, who rarely refer patients with dementia to psychiatrists or neurologists and only 15% of dementia patients receive anti-dementia medication. Geriatric day care is an important part of services but not many patients access them. Special dementia care in nursing homes is either a segregated or a partially segregated model. Results are presented comparing various types of services.

Spain has a complex political structure with 17 Autonomous Regions, but it also has a National Health Service (SNS). However, the political structure hampers generalised implementation of dementia care strategies, although the Autonomous Regions of Catalonia and Galicia are pioneers in this respect. Despite many examples of excellent services, the development of a National Strategy for the Care of Dementia is deemed of high importance.

Sweden has a national quality register: SveDem (Swedish Dementia Register) which is the world's largest dementia case register with more than 15,000 people registered. It links to national evidence-based guidance for diagnosis, treatment and care. However, service provision is at times disconnected, being provided by county councils and municipalities with increasing involvement of the private sector complicating matters. A common form of accommodation is group homes with 6–10 people per unit, but there are concerns about staffing levels.

In the United Kingdom memory services have gradually moved towards community based services and are often nurse-led, in part because of increasing numbers of referrals. The publication of the National Dementia Strategy has emphasised the importance of dementia and with the national accreditation programme of the Royal College of Psychiatrists is helping to develop and improve existing memory services.