This informal CPD article ‘From Evidence to Practice: Improving Dementia Training in Adult Social Care’ was provided by CAS Care Solutions, a domiciliary care provider established to support adults to live safely and independently in their own homes. They deliver compassionate support across a wide range of needs, including complex care.
Dementia is a progressive condition that affects cognitive functioning and presents uniquely in each individual. While most commonly associated with older adults, dementia can affect people at any stage of life (1). As the prevalence of dementia continues to rise in the UK and globally (1), the quality of care provided to people living with dementia is increasingly dependent on the knowledge, confidence, and competence of the workforce delivering that care (2).
This article explores how dementia training influences care practice, drawing on evidence-informed insights from frontline care staff. It focuses specifically on the gap between training and practice and highlights why personalised, interactive training can be essential for delivering truly person-centred dementia care.
Dementia Care and the Role of Training
Dementia encompasses a wide range of conditions, including Alzheimer’s disease, vascular dementia, frontotemporal dementia, and Lewy body dementia (3). Although these conditions differ in presentation, they often involve complex behavioural, psychological, and emotional changes that can challenge care staff in practice (4).
Health and social care providers have a legal and regulatory responsibility to ensure staff are appropriately trained for their roles. In England, this includes induction requirements, completion of the Care Certificate, and access to ongoing learning and development (5). However, evidence consistently shows that the quality, depth, and relevance of dementia training vary significantly across services (6).
Where training is limited or overly task-focused, care risks becoming routine-driven rather than person-centred (7). This can result in physical needs being prioritised while emotional, psychological, and social needs are overlooked—needs that are often expressed through behaviour rather than verbal communication (8).
Why Person-Centred Dementia Training Matters
Person-centred care recognises the individual behind the diagnosis and emphasises the preservation of personhood throughout the progression of dementia (9). When staff lack training in understanding behaviour, communication, and emotional expression, there is a risk that dementia-related distress is managed through restrictive practices or biomedical responses rather than compassionate, relational care (10).
Research has linked insufficient dementia training with:
- Reduced dignity and respect in care experiences (11)
- Increased task-orientated practice (7)
- Over-reliance on antipsychotic medication to manage distress (12)
- Lower staff confidence when supporting families (13)
Conversely, well-designed dementia training supports staff to interpret behaviour as communication, maintain personhood, and adapt care approaches to the individual (9, 14).
Insights From Frontline Care Staff
This article draws on qualitative insights from care staff working directly with people living with dementia. Although staff valued training overall, their experiences highlighted three critical themes relevant to workforce development.
1. Putting Training into Practice
More experienced staff consistently described training as most valuable when it could be applied directly in day-to-day care. Training that supported communication, emotional connection, and reminiscence enabled staff to engage more meaningfully with service users and tailor care beyond written care plans (14).
Staff described increased confidence in:
- Communicating with service users using life history and personal knowledge
- Supporting emotional and social wellbeing
- Building trusting relationships with families
This reflects wider evidence that effective dementia education must support behavioural change and practice improvement rather than knowledge acquisition alone (15).
2. Bridging the Gap Between Training and Confidence
Less experienced staff often described training in terms of how it made them feel—motivated, interested, or more aware—but struggled to link this learning to real-life practice, particularly when responding to distress, complex behaviours, or family concerns.
This mirrors findings from dementia education research, which shows that learning remains theoretical unless reinforced through mentoring, reflection, and practice-based support (15, 16). Without this bridge, staff confidence may remain low despite completion of mandatory training.
Confidence and competence are closely linked, and low confidence can negatively affect communication, decision-making, and engagement with families (13).
3. Learning Through Experience Alone Is Not Enough
Both newer and more experienced staff described learning primarily through experience rather than structured training. While experiential learning is valuable, relying on experience alone presents risks, including:
- Outdated or inconsistent practice
- Variation in care quality between staff
- Reinforcement of ineffective or restrictive approaches (6)
Effective dementia care requires continuous learning that integrates experience with current evidence, reflective practice, and updated training (2, 15).
Personalised engaging dementia training
The Case for Personalised and Interactive Training
A consistent message from staff was the need for personalised, engaging dementia training. Generic, diagnosis-led training was viewed as limited in its relevance to individual residents and real-world care challenges (17).
Staff highlighted that:
- Training should reflect the specific needs of people they support
- Activities and care strategies should be meaningful and relevant
- E-learning alone is often disengaging and insufficient
Interactive approaches—such as discussion, scenario-based learning, reflection, and practical examples—are consistently shown to improve learning transfer into practice (15, 17).
Measuring Training Effectiveness
Evaluating dementia training should focus not only on completion but on impact. Evidence suggests effective training demonstrates (15):
- Positive learner engagement
- Improved knowledge and confidence
- Observable changes in care practice
- Improved outcomes for people receiving care
Training that fails to progress beyond initial engagement is unlikely to improve care quality or experiences.
Implications for Providers and Leaders
For care providers, dementia training should be viewed as a strategic quality and safety investment rather than a compliance exercise. Evidence indicates that strong leadership and learning cultures are central to sustaining good dementia care (2, 6).
To strengthen dementia care, organisations should:
- Provide ongoing, role-relevant dementia training
- Embed mentoring and reflective practice
- Ensure training supports personhood and communication
- Involve staff in shaping learning content
- Evaluate training based on impact on practice
These approaches support staff confidence, reduce burnout, and improve the lived experience of people with dementia and their families (13, 15).
What Effective Dementia Training Should Achieve
Dementia training design should enable care staff to:
- Understand why dementia training must go beyond basic awareness and compliance
- Recognise the relationship between training quality, staff confidence, and care outcomes
- Identify gaps between dementia training and real-world practice
- Reflect on how personalised, interactive training can improve person-centred dementia care
- Consider leadership actions that strengthen training transfer into practice
Questions for Service Reflection
Care providers and training leads may consider:
- How does the dementia training currently offered within your service support—or limit—person-centred care in practice?
- How are staff supported to apply dementia training when responding to distress or supporting families?
- How do confidence and competence present within your team when managing complex dementia-related behaviours?
- What opportunities exist for mentoring, shadowing, or reflective discussion following dementia training?
- How could training be adapted to better reflect the histories and preferences of people living with dementia?
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References
(1) World Health Organisation (2016). Dementia Fact Sheet.
(2) Care Quality Commission (2017). The State of Health Care and Adult Social Care in England.
(3) Alzheimer’s Society (2008). Dementia Care Practice and Person-Centred Approaches.
(4) Hughes, J. et al. (2008). Dementia care and staff confidence.
(5) Care Quality Commission (2014). Cracks in the Pathway.
(6) Royal College of Psychiatrists (2011). National Audit of Dementia Training.
(7) Alzheimer’s Society (2014). Low Expectations.
(8) Kelly, F. (2009). Recognising and supporting personhood in dementia care.
(9) Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First.
(10) Banerjee, S. (2009). The Use of Antipsychotic Medication for People with Dementia.
(11) Care Quality Commission (2014). Cracks in the Pathway.
(12) Banerjee, S. (2009). The Use of Antipsychotic Medication for People with Dementia.
(13) Bosley, S. and Dale, J. (2008). Healthcare assistants’ role, job satisfaction and training needs.
(14) Chalfont, G. and Hafford-Letchfield, T. (2010). Inclusive training and learning for dementia care.
(15) Surr, C. et al. (2017). Evaluating dementia training effectiveness.
(16) Murphy, K. (2007). Effective dementia education and training methods.
(17) Surr, C. et al. (2017). Evaluating dementia training effectiveness.
