The most challenging aspect of dementia care is not the person or the disorder but the systems we have built around it?

For decades, dementia care has operated on institutional time, institutional routines, institutional definitions, where people living with dementia are often referred to with labelling terms and limited resources. We have measured success by compliance, efficiency, and risk reduction.

But what if we have been measuring the wrong things?

At PMH Consultancy and Education, we work alongside leaders like Pat Hobson, independent nurse consultant, dementia and safeguarding expert with 30+ years experience.

Pat's journey into dementia care began not in a classroom, but through her experience as a child watching her mother look after her grandmother. Watching people she loved navigate a world that did not have dementia care and how this compares with today reinforces the importance what how families and the person living with dementia should be at the centre of dementia care:

Dementia care must be shaped with people, not for them.

This principle has guided Pat's work across NHS services, care homes, mental health nursing, and dementia consultancy. The results speak for themselves: reduced distress, decreased medication use, empowered staff, and people living with dementia who feel seen, heard, and valued. This is what led her to develop the Unique Life, Unique World and Unique Environment - Model of Dementia Care Pathway, which she explores in her latest dementia book.

The question is not whether person-centred and person led care works. The question is: why are not more organisations implementing it?

What Does "Person Centred and Person Led Care" Really Mean?

In an era where titles can be meaningless, true dementia person centred and person led requires:

• Person Led Experience: People living with dementia and their caregivers are the experts, and professionals enable and empower them to lead in their care.
• Clinical and Social Care Depth: In depth understanding of how dementia as a diagnosis is only one attribute examined within the context of the person's personality, biography, physical health status and social psychology (which includes social and environmental factors).
• Person Led Communication: Interpreting emotional and behavioral language that is unique to the person
• Rights-based practice: Protecting personhood, autonomy, and dignity at every stage
• Real-world experience: Years in dementia care settings, where people living with dementia lead not just theory

Pat's "utopia dementia care service" model and pathway demonstrates what happens when we invert traditional care assumptions:

Traditional Approach: "The person must fit our system."
Person-centred and Person Led Approach: "Our system must fit the person."

This is not idealism… it is practical, evidence-based care that reduces crisis interventions, improves outcomes, and transforms staff satisfaction.

 The Revolutionary Act of Removing Time

One of Pat's most powerful interventions that really epitomises person centred and person led care is simple but effective: remove the concept of time from dementia care.

Time-driven care creates:

• Pressure and anxiety
• Rushed interactions
• Conflict over "cooperation"
• Staff frustration
• Loss of personhood

What happens when time is removed:

• The person leads the pace
• Staff adapt their approach
• Dignity is preserved
• Interactions become meaningful
• The person regains agency
• Distress measurably decreases

One care home that implemented this approach saw a 70% reduction in "behavioural incidents" within three months, not because behaviors were managed, but because the underlying causes were eliminated.

This is what transformation looks like.

Empowering Caregivers: The Missing Piece

Family and professional caregivers are essential partners in person centred and person led dementia care, but they cannot succeed in isolation.

Caregiver empowerment requires:

Knowledge

• Understanding what dementia is (and is not)
• Recognising how it affects perception, memory, and communication
• Learning to interpret behavioral communication

Support Systems

• Access to professional guidance
• Connection with other caregivers
• Respite and self-care resources
• Clear pathways for getting help

Practical Strategies

• Prioritising non-medication approaches first
• Focusing on remaining abilities, not just losses
• Allowing the person to guide their care whenever possible
• Knowing when medical review is needed

The crucial message: Caregivers and organisations are not failing when they struggle, they are under-resourced. With proper knowledge and support, caregivers and dementia care organisations succeed. 

 A Global Perspective on Local Care

Pat's work examines dementia care across nations, revealing both disparities and opportunities:

High-income countries often have better diagnostic tools, systems, processes, recourses and pathways however, over-rely on caregivers or 'unpaid' carers to support people living with dementia in their own home, who do not have the right support and often feel isolated.

Low-income countries face resource challenges, systems, processes and lack of pathways but often demonstrate stronger community-led, family-integrated care models, which are often person centred and person led.

What this teaches us:

• Technology and resources matter, but relationship and community matter more and are part of the person centred and person led care.
• Cultural approaches to caregiving offer lessons for all systems.
• Professional training gaps exist worldwide.
• Compassion and person-centred and person led are transcend economic boundaries.

Dementia is a global challenge. Person-centred and person led care is a universal solution.

Ready to Transform Your Approach?

At PMH Consultancy and Education, we partner with organisations and caregivers to implement person-centred and person led dementia care that works in the real world.

Our services include:

• Comprehensive dementia training tailored to your team's specific needs and care settings
• Person-centred and person care framework implementation with ongoing support
• Safeguarding integration ensuring rights-based practice becomes standard
• Environmental and systems audit identifying opportunities for transformation
• Caregiver empowerment programs for both families and professionals

PMH Professional Membership provides ongoing access to resources, expert guidance, and a community committed to transforming dementia care.

Whether you are looking for:

• CPD-accredited training modules on person-centred and person led dementia care
• Expert feedback on complex cases
• Templates and toolkits you can implement immediately
• Connection with professionals facing similar challenges

We have a membership tier designed for your needs.

→ Individual professionals

 → Organisations and teams 

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Book a free discovery call to explore how we can support your journey toward truly person-centred and person led dementia care.