Building a dementia care program that truly delivers isn’t about adding another service to a long menu; it’s about rethinking how care is experienced, felt, and lived by the people you serve. As dementia becomes more prevalent, families and clients alike are demanding support that goes beyond task checklists and generic training. They want care that understands who the person is, what comforts them, and how to anticipate needs before they escalate.
This means shifting from a one-size-fits-all model to one rooted in person-centered, relationship-centered care: an approach shown to improve quality of life and reduce behavioral symptoms by honoring each person’s preferences, history, and emotional well-being.
True excellence in dementia care also requires structured supports, ongoing education, real coaching, and systems that embed learning into daily workflows rather than relegating it to check-the-box training.
It means involving families as collaborators, using care plans that live and breathe, and preparing your workforce not just to do care, but to think deeply about it. This kind of investment in people, process, and culture is what separates standard care from truly meaningful dementia support.
To shed some light on the same, we interviewed a home care industry expert to bring her perspective on how to build a dementia care program that truly delivers.
Emily S. Gavin is an occupational therapist, coach, and dementia care expert based in the Philadelphia area, dedicated to easing the lives of dementia caregivers. Through her private practice, she provides evidence-based education, personalized coaching, and practical support to both paid and family care partners.
Emily champions person-centered, relationship-centered care that honors the individuality and well-being of people living with dementia, helping caregivers feel confident, connected, and truly effective every day.
Let us now delve into what she has to say about how to build a dementia care program that truly delivers.
One of the biggest mistakes home care agencies make is thinking that just showing up in scrubs counts as good care, especially for people with mild dementia. For someone living with cognitive changes, a caregiver in medical attire can feel intimidating or confusing, and it can actually push the person away rather than help them feel comfortable.
This reflects a deeper issue: many agencies say they provide companion care, but in reality, it isn’t done skillfully. True companion care isn’t just being present with someone. It’s about understanding who the person is, their interests, their life story, what they enjoy talking about, and what brings them comfort or joy. That requires real skill, empathy, and training.
So the most common mistake is focusing on the “task” of care without building a meaningful connection, especially failing to tailor interactions to the individual needs and personality of someone living with dementia. Skilled companion care makes a huge difference in whether a client feels safe, engaged, and respected.
I think this is a really important question. The key is having a real, living care plan, not just a checklist. Too often, care plans are just boxes to tick: what ADLs someone needs help with, what tasks to do, etc. But for dementia care, the care plan needs to go deeper. It should include:
Personal preferences & interests
These details should come from the family and be shared not just once, but ongoing, with both supervisory staff and the caregivers themselves.
Real collaboration with families
Families are a goldmine of insight into what works and what doesn’t for their loved one. Agencies should involve families in shaping and updating the care plan, so caregivers truly understand:
Make the care plan part of the workflow
Instead of a training manual that sits on a shelf:
In short: Embed person-centered care by making care plans meaningful, individualized, and collaborative, and by ensuring they are actively used every day, not just documented once and forgotten.
I think this really comes down to being proactive, and that starts with how agencies approach training and support.
Early signs of caregiver burnout are often overlooked
Agencies sometimes miss these signs because they treat dementia care training as a one-and-done checkbox rather than an ongoing support process:
These are subtle signs, not dramatic, but they show up long before a caregiver says, “I’m burned out.”
Why this happens
Dementia care is not something you learn in a single hour-long online training and then suddenly know. Too many agencies offer minimal, generic training and call it “dementia care.” But dementia support requires real strategies:
That level of skill can’t come from a one-time module. It needs ongoing learning.
What leaders should do sooner
Instead of waiting for burnout to become obvious:
This means learning real strategies that help caregivers anticipate needs and avoid distressing situations.
This is where a supervisor or trainer regularly checks in with caregivers, asks:
…and genuinely helps brainstorm solutions.
The outcome
When caregivers feel supported, not judged, they’re less likely to burn out. Investing in true skill development and real, human coaching leads to:
Question 4: Are there any unique regulatory, reimbursement, or workforce challenges in Pennsylvania that agencies should consider when building dementia care programs?
Yes, there are several important challenges and opportunities in Pennsylvania that home care agencies should be aware of when building dementia care programs:
Workforce shortages & reimbursement levels
Pennsylvania is currently facing a significant workforce crisis in home care and long-term services.
A large number of care shifts go unfilled because there simply aren’t enough caregivers available. This is primarily because Medicaid reimbursement rates for personal assistance services are relatively low, making it difficult for agencies to offer competitive pay and attract staff.
Low reimbursements have not kept pace with inflation or labor market needs, and this puts pressure on hiring and retention.
For anyone building dementia care services, this means you need a strategic plan for staffing, retention, and compensation to maintain quality care.
Medicaid reimbursement & cost gaps
Pennsylvania’s Medicaid coverage for long-term care services includes care services but not room & board in memory care settings, unlike some neighboring states.
This matters because families may still face a large financial gap even after qualifying for Medicaid, which can influence care planning decisions and client expectations.
For agencies, this means understanding the financial realities families face and being able to explain how services fit into state reimbursement structures.
Regulatory requirements
While Pennsylvania has licensing and compliance rules for personal care homes and long-term care environments (e.g., 55 Pa. Code Chapter 2600), these regulations are generally focused on safety and documentation rather than dementia-specific care standards.
This lack of dementia-centric regulatory guidance means agencies can differentiate themselves by going beyond the minimum standards through specialized training, relationship-centered care practices, and person-centered assessments.
Federal GUIDE Dementia Care Model opportunities
Pennsylvania is one of the states participating in the federal GUIDE (Guiding an Improved Dementia Experience) model, which pays for dementia respite services, care coordination, caregiver support, education, and training under Medicare.
This is not a state requirement. It’s a voluntary federal program, but it creates a unique opportunity for agencies that partner with the right organizations or become part of the networks delivering GUIDE services. That can help agencies:
Question 5: Looking ahead to 2026, how do you see dementia care expectations changing for home care agencies, and what should leaders start preparing for now?
Looking forward into 2026, several big shifts are happening in home care overall, and especially in how families and the industry expect dementia care to be delivered.
The market keeps getting more competitive
In places like Philadelphia, there are so many home care agencies that simply being “another option” doesn’t make you stand out anymore. If dementia care is going to be your agency’s differentiator, you can’t just claim expertise, you have to invest deeply in it. That means real education, real skill development, and real coaching, not surface-level training. Then you market and live that expertise, not just mention it on a website.
Families will expect more than task-based care
By 2026, clients and families will increasingly judge agencies by how well they help people live well, not just by how they complete tasks. That means expectations shift toward personalized, relationship-centered dementia support that truly understands the person behind the diagnosis.
This aligns with broader trends in senior care where holistic, person-centered support is rapidly rising as a priority across the industry.
Technology will play a bigger role, but not replace human connection
New tools like AI, remote monitoring, and smart integration, will be expected as part of care delivery. These can help enhance safety, predict risks, and free up caregiver time for deeper connection rather than busywork. Families will begin asking: “How are you using tech to make care better, not just faster?”
Skilled coaching and ongoing support will define quality
By 2026, basic dementia training won’t impress anyone. Leaders will need to embed ongoing coaching, collaboration, and reflective practice into daily workflows so caregivers are constantly improving, not just “trained once and done.” Agencies that invest in continued mentoring and reflective learning will differentiate themselves.
The way agencies market dementia care will change
Simply listing “dementia care” on a services page won’t cut it. Families and referral partners will start looking for proof:
Agencies should begin building the evidence of expertise now, through coaching programs, documented care strategies, and visible results.
In a landscape where dementia care expectations are rising, Emily S. Gavin reminds us that true quality isn’t defined by checklists or basic training, it’s defined by depth, connection, and continuous support.
Leaders who invest in real education, hands-on coaching, and relationship-centered practices will not only improve care outcomes but also build stronger teams and more meaningful family partnerships. As the industry evolves, agencies that live their expertise and demonstrate it every day will stand out.
Emily’s insights offer a roadmap for agencies ready to move beyond “good enough” and toward care that truly delivers.
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