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2017: Standards for Residential Care Facilities in Europe

Country comparisons

It gives me great pleasure to present this comparative report on standards for residential care facilities in Europe. Most people with dementia live in the community. However, some, may need to move into residential care due to dementia or other conditions. Also, some people living in residential care facilities may develop dementia at some point of their lives.

Moving into residential care is a significant life event and can be quite challenging for many people and this decision may be even more difficult for a person with dementia. Amongst the questions expressed by older persons are when to make the decision and which care home to choose as well as concerns over more practical aspects of care, such as having to share a room or not being able to decide about meals or when to go to bed.

Every person living in these settings should have the same rights and opportunities to enjoy a meaningful and good quality of life as people living in other settings. This is particularly true for people with dementia who may often have more complex needs than other residents and, as dementia progresses, may be less able to defend their interests and rights, make decisions or communicate preferences.

This report provides an overview of the existing care standards and regulatory requirements that residential care facilities need to meet. The report addresses key areas that have a great impact on the lives of residents, namely, the physical environment, the staff  providing care, health and social care and human rights, end-of-life care and abuse and restraint.

We identify some important oversights on how dementia is currently addressed or neglected in frameworks and standards in Europe, but were also able to provide examples of good practices and standards where the specific needs of residents with dementia have been taken into account. 

The report also draws attention to end-of-life care for people living in residential care settings. This is a great concern as many people, with and without dementia, will spend their last days and moments of life in a residential care facility. Abuse, and specifically, the use of restraint, is also an important topic in dementia care. Alzheimer Europe carried out work in 2012 on the area of restrictions of freedom and the use of restraint. The use of restraint, particularly on frail, older people with dementia, is generally considered unethical or harmful and is rarely if ever justifiable.

Some of the key issues that still need to be considered at policy level are the formulation of clear and legally binding standards with specific considerations of the needs of residents with dementia, appropriate training for staff, and awareness raising and the provision of high quality accessible information to residents, families and staff about their rights and what they should be able to expect from care.

In closing, I want to acknowledge the important work of our member associations and other national experts who provided the information for this report, and Ana Diaz, Project Officer, who coordinated this work and carried out this impressive comparison of national care standards. A special mention goes to the members of our European Working Group of People with Dementia and their supporters, who have provided very insightful personal accounts and thoughts on this important topic.

We hope this comparative report will be useful in advancing the understanding of this topic and improving the standards of care and the quality of life of people with dementia in residential care.

Jean Georges

Executive Director Alzheimer Europe






Last Updated: Monday 03 February 2020


  • Acknowledgements

    This Dementia in Europe Yearbook received funding under an operating grant from the European Union’s Health Programme (2014-2020). The content of the Yearbook represents the views of the author only and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.
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