Fragmented dementia care is not a local policy failure — it is a systemic pattern that repeats itself across radically different European healthcare architectures. That finding carries real weight for anyone tracking the long-term care burden of cognitive decline, which is projected to affect roughly 14 million Europeans by 2050. Understanding where coordination breaks down — and where it occasionally holds — has direct implications for the roughly 70% of dementia care that falls, unpaid, on family members.
This eight-country qualitative study drew on 86 participants interviewed between October 2025 and February 2026, spanning health professionals (n=22), social care professionals (n=13), unpaid carers (n=37), and people with dementia (n=14) across the Czech Republic, Ireland, Italy, Lithuania, Netherlands, Poland, Portugal, and the United Kingdom. Using framework analysis grounded in the Dementia Inequalities Model, researchers identified five consistent failure patterns: absent formal connective structures between health and social systems, entrenched silo working within professional sectors, low cross-sector knowledge and awareness, disproportionate burden falling on unpaid carers, and — notably — country-specific pockets of successful integration that suggested solutions are not one-size-fits-all.
What makes this study analytically interesting is not the existence of fragmentation — that has been documented before — but its cross-national consistency despite vastly different funding models, primary care architectures, and welfare state traditions. Whether a country operates a Bismarckian insurance model or a Beveridge-style national health service, siloing persists. This points away from structural financing as the root cause and toward professional culture, training gaps, and the absence of mandated coordination protocols. The qualitative methodology captures experiential nuance that epidemiological datasets miss, though the modest sample size (86 participants across eight countries) limits generalizability, and the reliance on professional self-report introduces social desirability bias. This is best understood as a hypothesis-generating, paradigm-framing contribution rather than a definitive causal account — but as the first cross-national qualitative mapping of this specific failure mode, it sets a valuable baseline for future intervention research.
