Responding to the Royal Commission’s recommendations on dementia care

Tamar Krebs, Founder and CEO, Group Homes Australia

In this guest post, Tamar Krebs – Founder and Co-CEO of Group Homes Australia, shares insight into their approach to dementia care, and how these learnings can be applied to recommendations in the Royal Commission’s Final Report.

Dementia is a growing challenge. We are living longer and diagnosing it better. This creates a critical need for appropriate care models for this ballooning cohort of Australians. Every day, 250 people are diagnosed with dementia in Australia, and this number is expected to rise to 318 people per day by 2025. If we don’t address dementia as a specific care need, the cost to our country will become unmanageable as families and care workers struggle, and care settings are ill-equipped.

At this point in time, there is a shortfall in the system. Funding does not match the needs of the community; we are not able to seamlessly navigate different care options or access funding when it is needed. There has been a focus on nursing home and clinical models, rather than the benefits of small-scale, social models, and this has been highlighted in the Royal Commission findings. We talk about people suffering with dementia rather than focusing on supporting people to live beyond a diagnosis of dementia. There is a fear in our community that surrounds dementia. This fear is created from a lack of understanding and fear of the future of care. For those living with dementia, there is a challenge for them and their care partners to find the right kind of care, so that they can be supported to live rather than suffer. This system can be a minefield to navigate and is not made easier by an extra layer of emotion.

In recommendation 45 of the Royal Commission into Aged Care, it states that we should be “creating ‘familiar households’ facilities…small household models usually involve housing 8-10 people receiving aged care services within a home-like environment… and a focus on domestic, homelike, familiar or normalised environments with medical equipment hidden. Regular staff are employed, and they do not wear uniforms.” This relates directly to our Group Homes Australia model and describes the features of our 12 homes in Sydney.

The Group Homes Australia model is a small-scale social model that focuses on residents abilities rather than their disabilities. It has health and social benefits, supports dignity of choice and engages residents to live beyond their diagnosis. Our group homes have 6-10 residents with 24/7 dedicated care. Our innovative model of care is an alternative to traditional aged care facilities. Smaller care environments have been proven to increase quality of life, reduce rates of depression and reduce hospitalisation for people living with dementia.

Research shows that health outcomes in smaller environments are superior to traditional nursing homes. Group Homes are not designed like care facilities – they’re homes first and foremost. Our Homemakers work alongside residents to get them involved in all sorts of day-to-day activities of living. This could be cooking, gardening, or shopping: anything that is purposeful and meaningful for that person. Yes, Homemakers need to be able to cook a meal – but just as importantly they need to be able to work alongside residents to encourage and support those who want to be involved in cooking meals, encourage involvement in serving the meals and sitting at the dining room table, with the residents, engaging in conversation during the meal.

It’s also a dementia-specific environment, which means we’ve thought about how to make the space engaging, functional and purposeful. No matter where a resident goes in a GHA home, the environment is friendly and functional. It looks and feels like an ordinary home – it doesn’t feel like an institution.

Residents know that a living room is a living room because there is a lounge, a coffee table, family photo albums, a resident’s knitted blanket that they brought from home, and maybe even a pet, or a basket of laundry waiting to be folded, and a fireplace, creating a warm, cosy environment. The kitchen looks and smells like a kitchen where there are freshly baked muffins, the kettle ready to be boiled and a soup simmering on the stove. Before a meal, residents will be encouraged to participate in chopping and peeling vegetables and setting of the table. The garden is open and inviting. A resident will walk into the garden and find a vege patch that needs to be watered, leaves that need raking and a space that is tranquil and inviting.

The summary of the Royal Commission report also mentions the importance of remaining in the local community whether this is in your own home or in a home-like setting, “accommodation located close to shops and other amenities is not only convenient but may also help to maintain social engagement with the local community”.

It’s important for residents to remain active in their local communities to ensure residents can maintain their social connections and continue their routines surrounding shopping, appointments and social engagements in the local community, with any support they require. Supporting residents to remain integrated within the local community can ultimately add more value to those living with dementia, and the community.

This summary also mentions that “people’s accommodation should cater to their changing needs.” We support this point and believe that it can support residents throughout their journey, and allow people to age in place, like at Group Homes Australia.

We believe that small scale living environments such as Group Homes Australia allow community members to live beyond a dementia diagnosis, to flourish and ultimately receive the quality care they need and deserve. When people are given the dignity, respect and care that they need in the best setting that suits them then there is ultimately more value to the community.

By providing a more trustworthy and clear system for navigating the industry, will help those seeking care, find the best option for them. It can create a better quality of life for residents, families who feel supported and a health system that is not overhauled.


  1. Tamar brings “Mindfulness” to dementia care, mindfulness of each individual’s needs, want’s and fears providing them with a safe haven, a feeling of inner security on their often frighteningly overwhelming journey into the last stages of their lives. Mindfulness coupled with familiarity and genuine care leads to transformative care.

    Tamar is single-handedly “Transforming” dementia care.

    Perhaps (to my mind), her greatest success is that she is able communicate her vision, purpose and her principles of mindfulness, devotion and passionate dementia care with all of her team members, who in turn, are playing their roles in delivering Tamar dream in the not-surprisingly rapidly growing (Group Homes Australia) network Tamar has spawned.

    Shine your light on the world Tamar, it desperately needs it!


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