2. The Historical Development and State of the Art Approach to Design and Delivery of Dementia Care Services

  1. Hugo de Waal MD, FRCPsych, FHEA6,
  2. Constantine Lyketsos MD, MHS7,
  3. David Ames BA, MD, FRCPsych, FRANZCP8 and
  4. John O'Brien BA, BM BCh, MA, FRCPsych, MD9
  1. Christopher M. Callahan1,
  2. Helen C. Kales2,
  3. Laura N. Gitlin3 and
  4. Constantine G. Lyketsos4

Published Online: 7 JUL 2013

DOI: 10.1002/9781118378663.ch2

Designing and Delivering Dementia Services

Designing and Delivering Dementia Services

How to Cite

Callahan, C. M., Kales, H. C., Gitlin, L. N. and Lyketsos, C. G. (2013) The Historical Development and State of the Art Approach to Design and Delivery of Dementia Care Services, 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.ch2

Editor Information

  1. 6

    Lead Consultant, Norfolk Dementia Care Academy, Norwich, UK

  2. 7

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

  3. 8

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

  4. 9

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

Author Information

  1. 1

    Indiana University Center for Aging Research and the Regenstrief Institute, Inc., USA

  2. 2

    Department of Psychiatry, School of Medicine, University of Michigan, USA

  3. 3

    Center for Innovative Care in Aging, Department of Community-Public Health, School of Nursing, USA

  4. 4

    Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA

Publication History

  1. Published Online: 7 JUL 2013

ISBN Information

Print ISBN: 9781119953494

Online ISBN: 9781118378663



  • historical development of dementia services;
  • clinical epidemiology of dementia;
  • societal perception of dementia;
  • delineation of dementia syndrome;
  • state-of-the-art dementia services;
  • design of dementia services;
  • evidence based design of dementia services;
  • psycho-social interventions;
  • biomedical interventions;
  • non-pharmacological interventions


Dementia is a disease category with until recently a very limited therapeutic arsenal, resulting in relative indifference within the medical profession. Coupled with an unfortunate element of ageism and a political disinterest in a patient cohort with little visibility, little astute advocacy and no economically relevant profile, dementia sufferers were on the receiving end of therapeutic nihilism on one hand and were considered of low priority in already stretched health care systems on the other. This chapter describes some of these historical aspects and analyses the relatively recent changes in these perceptions and how these – and other aspects – have contributed to an improved recognition of the need of such services. It then describes what should be included in dementia services, what could be considered as its aims and objectives and what evidence can be produced to provide the rationale behind various service components and configurations.