Dementia care is one of the most deeply human responsibilities in the care sector. Yet even with the best intentions, there can be a gap that quietly limits the quality of support many people receive: the difference between knowing about dementia and understanding dementia care. This is not merely another area of compliance – it’s the foundation of whether your service truly feels like home to the people who live there. Understanding with the head, yes, but also with the heart.

In this 9-part series, developed by NaDCAS in partnership with Care England, we explore the key focus areas of the NaDCAS Framework for Dementia Care. Each article shines a light on one vital area of practice, sharing insights, reflections, and practical information to improve the lives of people living with dementia. We begin this series with the foundation of it all: knowledge and understanding of dementia care.

When Knowing the Facts Isn’t Enough

You already know the clinical side: the types of dementia, the symptoms, the progression. But knowledge that stays in the head is only half the story. Understanding is something different. It’s recognising that dementia affects every person uniquely, and that what you see isn’t always the whole picture. Dementia is not one single condition, but a progressive neurological journey that can affect memory, mood, mobility, language, sensory perception, and behaviour, often in ways that change from one day to the next.

For someone living with dementia, the world can feel unfamiliar, unpredictable, even frightening. And because every person experiences it differently, we cannot rely on a one-size-fits-all approach. If we stop at “knowing the facts”, we risk delivering care that is reactive and task driven. But when knowledge and understanding are truly embedded, when it’s lived and breathed by the whole team, care becomes responsive, relational, and deeply human.

Consider this scenario: one team member completes the morning round efficiently but with minimal interaction; another takes the same amount of time but leaves the person living with dementia smiling and feeling loved. The difference? One completed a task, the other connected. You can have a strong rota, the most efficient medication rounds, spotless inspection reports, and the best-equipped rooms, but if your team doesn’t deeply understand dementia care and seek connection with every interaction, something vital will be missing.

Why Does This Matter?

If we try to step into the shoes of someone living with dementia, the room can look familiar, but somehow not quite homely. The sound of voices can blend into a confusing hum rather than feeling comforting and familiar. The clock says one time, but your body feels like it’s another. The air feels a little too warm, or maybe too cool, but you can’t find the words to say so. Faces pass by, and you search for the right name, but it hovers just out of reach. Even the simple act of standing up feels uncertain, as if the floor beneath you might shimmer and shift.

Now imagine that’s every day.

People may be searching for an object, a place, or a person that can lead them to a feeling of safety, comfort, or being occupied. They may not have the words to explain it, but the need is still urgent. When a team understands this, “wandering” isn’t a problem to be stopped; it’s an expression of need to be met. And instead of an intervention, you’ll walk with them, sharing the search, showing understanding and creating a connection rather than distress.

When a care worker takes the time to slow down, use clear and familiar language, maintain eye contact, and truly understand, they are doing more than completing a task – they are helping someone connect and feel secure in their surroundings.

Stepping Into Their Experience of the World

The moment you try to walk into someone else’s experience of the world, and the rules are different, the past and present can mix freely. Priorities can shift. Time can run fast or slow. Your version of reality isn’t always the most important one.

This is where great dementia care starts: leaving your world at the door and looking into their reality.

Correcting someone rarely builds a connection but meeting them where they are now and trying to understand them is almost always better. If a person living with dementia believes they’re waiting for their children to come home from school, you can sit with them in that moment – ask about their children, share memories, offer comfort and provide the love that their children gave them. It’s about entering their lived reality, not bringing them into ours.

 

“Dementia happens in the brain. Dementia care happens in the heart.”

 – Waiting for the Bus, Sam Dondi-Smith

The Ripple Effect of Real Understanding

For the people you support, understanding means dignity, comfort, and emotional safety. For their families, it means peace of mind – knowing their loved one is seen as the person behind their diagnosis, not merely a task on a list.

For your team, it’s just as transformative. Team members who ‘connect’ feel more confident, more purposeful, and more valued in their work. That energy spreads, creating a calmer, warmer atmosphere that visitors can feel the moment they walk in.

It also makes a home stand out, not just in inspection reports, but in reputation, word of mouth, and staff retention.

How to Develop a Culture of Understanding in Your Care

We know that training on dementia (the condition) alone isn’t enough. Understanding of dementia care needs to be woven into daily life. That takes intention, leadership, heart, and persistence.

‘Knowledge and Understanding of Dementia Care’ is the first key focus area of the NaDCAS Framework, which outlines some evidence-based methodologies to enhance practice in your home, including:

• Life Story Work – make sure every team member knows the history, preferences, and routines that shape a person’s sense of self.
• Scenario-Based Learning – team training on real-life situations they’ll face, from understanding distress and promoting choice to managing repetitive questions with patience.
• Non-Pharmacological Interventions – music therapy, reminiscence therapy, and sensory engagement that connect people with people beyond words.
• Environmental Design – spaces that are familiar, homely, easy to navigate, and free from unnecessary stressors and clinical tones.
• Reflective Practice – regular sessions where staff share what they’ve learned, celebrate successes, and problem-solve together.

The role of the leader is to model it yourself. When you slow down to greet a person warmly, connect with them, or join them in their search, you’ll see how much this approach matters and how others will absorb it.

The NaDCAS Perspective

Our framework was developed with input from dementia experts, care leaders, practitioners, researchers, and people with lived experience of dementia. Our focus is not just identifying areas for improvement, but actively supporting teams to grow, with feedback, insight, and practical development pathways. Turning expert knowledge, backed by research, into a culture you can feel when you walk through the door.

Knowledge is the foundation, but the real measure is in how it is used in practice.

Your Next Steps

If you want your team to go beyond simply “knowing the facts” and create an environment where understanding becomes instinctive, the NaDCAS Framework is your starting point. Every focus area is explored in depth, with practical guidance, sector insights, and evidence-based approaches that empower the team, from frontline teams to leadership, to raise the standard of dementia care.

Stay tuned for our upcoming NaDCAS x Care England Webinar, our eight upcoming weekly articles, and our comprehensive paper, all designed to spark reflection, inspire improvement, and ultimately deliver better outcomes for people living with dementia across the UK.

🔗 Explore the NaDCAS Framework and see how it can shape your service or register your interest in NaDCAS Accreditation at: www.nadcas.org