· Executive Brief
World Alzheimer’s Month 2026
An executive-guidance framework for coordinated messaging, visible ownership, and a measured improvement cycle.
Leadership signal
World Alzheimer’s Month can serve as an executive operating checkpoint.
Coordination matters when multiple teams participate. An executive review can prevent conflicting instructions, unowned inquiries, duplicated outreach, and disconnected follow-up by establishing a shared brief, named owners, and a visible exception process.
Start by distinguishing what is known from what the organization still needs to learn. A campaign plan, communication volume, or meeting count does not establish that a route is usable. Leaders need direct listening, clear ownership, locally defined measures, and a method for keeping exceptions visible.
Executive opening
Dementia care is a coordination problem that starts in primary care
World Alzheimer’s Month asks the public to think about dementia for a few weeks, but health systems manage it for years. The work that shapes outcomes is coordination. It depends on whether primary care recognizes cognitive change and whether a diagnosis is followed by a care plan. It also depends on whether caregivers receive training that fits their lives and whether transitions between hospital, home health and long-term care hold together. Each of those links has an owner, a measure and a failure mode that leaders can inspect.
The diagnostic front door is narrow for a very large population. Dementia affects more than 55 million people worldwide, a figure projected to rise to 139 million by 2050.[3] Yet diagnosis in primary care remains substantially lower than expected, which delays access to treatment, support and future care planning.[6] Every later step in the continuum inherits that delay. A person without a diagnosis cannot be enrolled in caregiver support, case management or advance planning.
Coordination models exist, but their effects are uneven. A telephone-based collaborative care program with care navigation raised caregiver self-efficacy before the person’s death, yet caregiver satisfaction with end-of-life care did not differ from usual care.[8] An online, competency-based training program for Medicaid-funded home care workers improved knowledge and self-efficacy but did not reduce emergency room visits or hospitalizations.[15] Leaders should expect partial gains and measure them honestly.
This brief adds the evidence base behind the operating guidance already on this page. The sections that follow cover current evidence, the continuum from first concern to end of life, access, equity, the workforce and public communication. Each draws only on peer-reviewed studies and points to where coordination most often fails. Where the evidence is thin or mixed, the brief says so.
Current evidence
What the research says about diagnosis, collaborative care and caregiver support
Simple changes to primary care workflow can raise diagnosis. In a diverse Los Angeles County family medicine clinic, a brief bilingual screening tool was embedded in the electronic health record and offered before annual wellness visits.[1] Among 1515 eligible patients after launch, 1249 completed screening.[1] New dementia diagnoses rose from 0.75% before the tool to 2.45% among patients who screened positive, with an adjusted odds ratio of 2.99.[1] Medications, laboratory orders and specialty referrals also increased, while imaging did not.[1] The pre-post design cannot rule out other changes over time, but the result shows that a short, routine step can change practice.
Biomarker use in primary care is still early. In a nationally representative survey of 2574 primary care providers who treat Medicare beneficiaries with dementia, 79% reported using CT or MRI and 71% neuropsychological testing.[2] Only 16% reported plasma testing and 9% cerebrospinal fluid testing, and providers confident in diagnosing dementia were more likely to order newer tests.[2] The authors called for guidelines to inform primary care decisions about biomarkers.[2] Because the survey reflects the year after Medicare expanded coverage for some biomarkers, it offers a baseline for tracking change.[2]
Continuity is a recurring signal in collaborative care. In a retrospective cohort of 738 community-dwelling people newly diagnosed with dementia and behavioral symptoms, a case manager–centered collaborative model was associated with reduced short-term symptom severity and caregiver distress.[9] People dismissed during follow-up had higher symptom scores one year after diagnosis than those with continuous follow-up.[9] Discontinued follow-up was also associated with higher caregiver distress.[9] The study was retrospective, so continuity may partly mark families with more resources rather than explain better outcomes on its own.
Online caregiver programs deserve realistic expectations. A meta-analysis of randomized trials found no statistically significant short-term effect on caregiver burden, with a standardized mean difference of −0.06 across 13 studies.[11] Three studies suggested an improvement in self-efficacy, with a standardized mean difference of 0.20, but the evidence grade for both outcomes was low.[11]
Workforce training shows a similar pattern of process gains without clear outcome change. In a stepped-wedge trial of dementia training for home care workers, total costs rose from AU$68,925 in the control phase to AU$133,660 in the intervention phase.[13] The analysis found no clear evidence of improvement in selected client and caregiver outcomes, although the authors note that the main trial outcome was worker competence.[13]
Figure 1
Diagnostic readiness in primary care remains uneven
Percent of patients or primary care clinicians, as reported in each study. Values are copied from the cited studies [1], [2], [7]; none is estimated.
Data note. The two diagnosis rates come from one pre-post study, but the other bars come from different studies, countries and measures, so this is an indirect comparison; the chart shows where diagnostic readiness is thin, not how one setting compares with another.
Limitation. Each value reflects its own sample and definition; the post-period diagnosis rate is among patients who screened positive, and the survey values are self-reported.
Figure data (5 rows)
| Measure | Value | Population, setting and year as reported | Source |
|---|---|---|---|
| New dementia diagnoses before the screening tool | 0.75% | Patients aged 60 and older without prior dementia diagnosis, Los Angeles County family medicine clinic, February 2021 to August 2022 | [1] |
| New dementia diagnoses among patients screening positive after the tool | 2.45% | Post-intervention period January 2023 to June 2024; adjusted odds ratio 2.99 | [1] |
| Primary care providers reporting plasma biomarker use | 16% | Nationally representative survey of 2574 U.S. primary care providers treating Medicare beneficiaries with dementia, 2024 data | [2] |
| Primary care physicians who mainly refer suspected dementia | 83.1% | National online survey of 275 primary care physicians in the Philippines, 2024 to 2025 | [7] |
| Primary care physicians reporting a need for more training | 97.5% | Same Philippine survey of 275 respondents | [7] |
Continuum of care
From first concern through transitions and end of life
The continuum begins when someone notices a change and tries to be heard. Interviews with 37 Australians who had navigated diagnosis found that successfully communicating concerns and asserting candidacy shaped the diagnosis trajectory.[4] Participants described barriers that included primary care time and workload constraints, dementia-specific knowledge and inconsistent referral pathways.[4] Access to referral depended on an interplay of actions by people with symptoms, significant others and primary care physicians.[4]
Primary care practice itself is variable. Australian primary care stakeholders described family concern as the usual trigger for investigation, general practitioners delaying conversations about dementia and variability in post-diagnostic care.[5] Routine cognitive assessments were completed as part of the 75+ health assessment.[5] The interviews were designed to inform a practice change program rather than to measure performance.[5]
Transitions between hospital and home health are where medication errors can start. Role ambiguity, meaning a lack of clarity about who should complete medication tasks, can lead to adverse events for older adults with dementia.[14] Family caregivers and home health professionals working in refinement teams, 14 members in all, developed 31 strategies to address it.[14] Top strategies included workflows for accurate information, notifying primary care after discharge, secure medication storage, cognitive aids and dementia-specific training for home health staff.[14] Several of these strategies are operational rather than clinical, which places them within reach of system leaders.
Crisis admissions are the costliest failure of the continuum. They are increasing and often lead to negative outcomes for people with dementia, caregivers and professionals.[10] A meta-ethnography of 19 studies found that crises unfold as everyone balances safety and autonomy after a stable situation is disrupted.[10] A proactive, collaborative attitude among professionals helped, while a health system acting as a push system limited flexibility and responsiveness.[10] The authors recommended collaborative care approaches to prevent or manage crises more effectively.[10]
End of life tests the whole chain. In the Care Ecosystem trial, families valued emotional and practical support from care navigation.[8] Caregiver satisfaction with end-of-life care did not differ from usual care, with an adjusted odds ratio of 1.42.[8] They also wanted more anticipatory guidance, more information about hospice, earlier referral and better coordination with the healthcare team.[8] Each of those requests describes a handoff that could be planned before a crisis rather than improvised during one.
Figure 3
Why the pathway breaks
People
- Primary care time and workload constraints
- Gaps in dementia-specific knowledge and confidence
- Sole informal caregivers without backup
Process
- Inconsistent referral pathways
- Role ambiguity in medication management after discharge
- Follow-up discontinued after diagnosis
Technology
- Risk-alert tools incompatible with practice software
- Incomplete electronic record data
- Screening tools not adapted for language or culture
Environment
- Neighborhood disadvantage and rurality
- Stigma and normalization of dementia as aging
- Health system acting as a push system in crises
Policy
- Lack of financial incentives for diagnosis work
- Limited guidance on biomarker use in primary care
- Services hard to obtain after diagnosis
Measurement
- Training judged on knowledge, not client outcomes
- Utilization outcomes not reviewed with training results
- Costs not reported alongside outcomes
Unranked qualitative cause-and-effect diagram for the outcome in the box: People with cognitive change are diagnosed late, and after diagnosis their care is not coordinated across primary care, home care, home health and hospital Causes are assembled from the cited literature [1], [2], [3], [4], [5], [6], [9], [10], [12], [13], [14], [15]; categories are not weighted and their order carries no meaning.
Data note. Qualitative; no frequencies are implied.
Limitation. Causes drawn from published studies may not all apply locally; validate them with frontline teams.
Figure data (6 rows)
| Category | Causes drawn from the cited literature |
|---|---|
| People | Primary care time and workload constraints; Gaps in dementia-specific knowledge and confidence; Sole informal caregivers without backup |
| Process | Inconsistent referral pathways; Role ambiguity in medication management after discharge; Follow-up discontinued after diagnosis |
| Technology | Risk-alert tools incompatible with practice software; Incomplete electronic record data; Screening tools not adapted for language or culture |
| Environment | Neighborhood disadvantage and rurality; Stigma and normalization of dementia as aging; Health system acting as a push system in crises |
| Policy | Lack of financial incentives for diagnosis work; Limited guidance on biomarker use in primary care; Services hard to obtain after diagnosis |
| Measurement | Training judged on knowledge, not client outcomes; Utilization outcomes not reviewed with training results; Costs not reported alongside outcomes |
Access
Opening the primary care door and keeping support reachable
Access barriers are layered. A systematic review and meta-synthesis of 43 studies from 18 countries grouped them into patient, caregiver, provider, system and structural domains.[3] System-level barriers included fragmented care pathways, long waiting times and poor care coordination.[3] Provider-level barriers included insufficient training, therapeutic nihilism and time constraints, and caregiver-level barriers included burden and late symptom recognition.[3] Facilitators included caregiver advocacy, strong patient-GP relationships, dementia literacy campaigns, memory clinics and integrated care models.[3]
Practice change programs can stall on reach. A process evaluation of a multicomponent program in Australian general practice found that participating clinicians reported increased confidence and valued education, resources and benchmarking.[6] Overall reach was limited by competing clinical priorities, workforce pressures, lack of financial incentives and implementation challenges.[6] A dementia risk-alert tool was feasible but saw limited uptake because of software compatibility, usability concerns and incomplete medical record data.[6] The authors concluded that limited reach constrained the program’s potential impact, even though participating clinicians found it acceptable.[6]
Design choices can lower the threshold. The Los Angeles screening tool takes under five minutes and was translated and culturally adapted for Spanish-speaking patients before being embedded in the record.[1] Brevity, language adaptation and placement before a routine visit are all access features rather than clinical changes. New diagnoses in that clinic came with more medications, laboratory orders and specialty referrals, which signals downstream demand that must be staffed.[1]
Remote models extend reach when travel is a barrier. The Care Ecosystem model is delivered by telephone, with care navigation for people with dementia and their caregivers.[8] Its trial randomized 138 dyads to the model and 76 to usual care in the pre-mortem cohort.[8] Online caregiver programs may improve self-efficacy, although their effect on burden was not significant in pooled trials.[11] Remote delivery is therefore a reach strategy that still needs outcome tracking.
Community and policy barriers remain. Australian stakeholders summarized community-level barriers as “It’s hard to get services” and policy-level barriers as “If it’s not financially viable, it won’t be done.”[5] Leaders who want earlier diagnosis need a funded downstream service for every newly diagnosed person, or the front door simply opens onto a longer queue. Those phrases capture why diagnosis targets alone rarely change practice.
Executive guidance · System route
Build one visible operating route for World Alzheimer’s Month.
Use this route as a discussion framework. Replace each stage with the organization’s approved process, qualified roles, current service capacity, and applicable requirements. Do not infer a clinical protocol from the observance title.
The route at a glance
- Define the purpose
- Align the entry point
- Support complex navigation
- Manage response
- Review the campaign
Reliability rule: Every stage needs a named owner, an observable status, an approved escalation path, and a defined signal that shows whether responsibility moved or remained unresolved.
Define the purpose
Name the audience, intended action, approved message, and limits of what the campaign can responsibly promise.
Align the entry point
Connect every communication channel to current information and a clearly identified receiving role or team.
Support complex navigation
Make contact options, receiving services, communication support, transition status, and follow-through visible without assuming one experience or route.
Manage response
Keep questions, referrals, exceptions, and unresolved work visible until an accountable receiver accepts them.
Review the campaign
Compare intended action with local process signals and partner feedback, then document the improvement to carry forward.
Figure 2
The system route as one flow
The five stages of the system route described in this brief, drawn as one flow with a learning loop back to the start. The stages are the page’s original executive guidance, not a clinical protocol.
Data note. Shows sequence and handoffs only; it carries no counts or rates.
Limitation. Local processes may add, merge or reorder stages under organizational policy.
Figure data (5 rows)
| Stage | What the stage requires |
|---|---|
| Define the purpose | Name the audience, intended action, approved message, and limits of what the campaign can responsibly promise. |
| Align the entry point | Connect every communication channel to current information and a clearly identified receiving role or team. |
| Support complex navigation | Make contact options, receiving services, communication support, transition status, and follow-through visible without assuming one experience or route. |
| Manage response | Keep questions, referrals, exceptions, and unresolved work visible until an accountable receiver accepts them. |
| Review the campaign | Compare intended action with local process signals and partner feedback, then document the improvement to carry forward. |
Equity and trust
Disparities in risk, diagnosis and support
Underdiagnosis is not evenly distributed. Alzheimer’s disease affects over 10% of adults aged 65 and older, and Black and Hispanic or Latino individuals experience 1.5 to 2.0 times higher prevalence than White individuals.[1] The disease remains underdiagnosed, particularly in non-White populations, and common screening tools are limited by time burden and cultural sensitivity.[1] The Los Angeles tool was translated and culturally adapted for Spanish-speaking patients.[1]
Place shapes risk as well as access. Among older U.S. patients starting dialysis between 2003 and 2021, those in high-disadvantage neighborhoods had a higher risk of dementia diagnosis, with an adjusted hazard ratio of 1.09.[12] Black patients in high-disadvantage neighborhoods had an adjusted hazard ratio of 1.19 for dementia compared with Black patients in low-disadvantage neighborhoods.[12] The authors called for cognitive screening and collaborative care to address these structural barriers.[12] Higher risk in high-disadvantage neighborhoods also appeared within suburban, rural and small-town areas.[12] The study used ZIP codes as a proxy for neighborhoods, which the authors listed as a limitation.[12]
The access meta-synthesis found that disparities were consistently greater for ethnic minority groups, rural populations and people with lower socioeconomic status.[3] Patient-level barriers included stigma, denial, symptom normalization and limited health literacy.[3] Structural and societal barriers included rurality, poverty and ethnic minority status.[3] Equity work therefore needs both outreach and a service model that does not depend on families already knowing how to ask.
Global evidence shows the same pattern of normalization. Primary care physicians in the Philippines described local terms that frame dementia as part of aging and reflect perceived stigma.[7] Only 11.3% met the threshold for high knowledge on the study’s checklist, though the authors cautioned that item-level findings were more informative than score categories.[7] Equity work in dementia must therefore reach clinicians’ beliefs as well as patients’ access.
Family structure is also an equity issue. In the collaborative care cohort, people cared for by a sole informal caregiver had higher symptom scores, and their caregivers reported higher distress.[9] Families without backup appear to carry more of the load, so stratifying caregiver support by household structure is a practical equity step. Leaders can ask whether their caregiver programs reach single caregivers, rural families and communities that normalize memory loss.
Human infrastructure
Primary care, home care and home health teams carry the model
Primary care readiness varies widely. In a national survey of 275 primary care physicians in the Philippines, 83.1% primarily referred suspected dementia for diagnosis and management, and 16.9% reported independent diagnosis and management.[7] Nearly all, 97.5%, reported needing additional training, and 86.2% preferred online delivery.[7] Confidence in managing behavioral and psychological symptoms was low to moderate.[7] Among 42 respondents who described their own approach, history and functional assessment were most common, at 78.6%, while formal diagnostic criteria were used by only 4.8%.[7]
The home care workforce provides much of the daily support. A multi-week, competency-based online training for caregivers in California’s Medicaid-funded In-Home Supportive Services program improved dementia knowledge and self-efficacy.[15] It did not reduce caregivers’ distress or depression, and it did not decrease care recipients’ emergency room visits or hospitalizations.[15] The authors pointed to bolstering caregiver well-being and expanding access to training as next steps.[15] Because the evaluation used a quasi-experimental design, its null results on utilization are a signal rather than a final verdict.[15]
Training carries real costs that boards should see. In the Australian home care trial, the adjusted mean difference in total costs between phases was AU$67,146.[13] The authors advised reading the economic results alongside the main trial findings on worker competence.[13] A training investment should therefore be judged on the outcome it was designed to change, with client outcomes tracked separately.
Home health and hospital teams share responsibility at transitions. Dementia-specific training for home health staff was one of the top strategies proposed to reduce role ambiguity in medication management.[14] In crisis situations, a proactive, collaborative attitude among professionals was a key contextual factor.[10] Australian stakeholders also described hierarchy as a barrier to team communication in primary care.[5] Those findings point to team design, not individual effort, as the main lever.
Workload is the constraint behind many of these findings. People navigating diagnosis described primary care time and workload constraints as barriers to timely referral.[4] Workforce pressures limited the reach of the Australian practice change program.[6] Any new screening or collaborative care step needs protected time, a named role and a realistic caseload. The case manager model in the collaborative care cohort is one example of a role built for that purpose.[9]
Executive guidance · Operating dashboard
Use a small dashboard to expose friction and ownership.
Do not publish a number until the organization defines its numerator, denominator where relevant, owner, source system, exclusions, review cadence, and limits. The candidates below are management prompts, not benchmarks or reported results.
Four operating signals
Each signal pairs an executive question with one candidate local measure, set out below.
Executive guidance · Signal
Message alignment
Do channels and partners communicate one current and appropriately bounded route?
- Candidate local measure
- Content review status, conflicting instructions, corrections, and unresolved questions.
Executive guidance · Signal
Response ownership
Does every campaign-generated request reach an accountable receiver?
- Candidate local measure
- Routing, acknowledgment, repeat contact, unresolved work, and escalation signals.
Executive guidance · Signal
Navigation and communication
Can people and support networks understand who owns the next step and how to raise an unresolved barrier?
- Candidate local measure
- Locally defined communication barriers, repeated contacts, transition acceptance, support requests, and route completion.
Executive guidance · Signal
Action closure
Did leaders complete and verify the improvement selected for the campaign window?
- Candidate local measure
- Assigned action, status, evidence of completion, and post-action review.
Figure 4
The operating system behind the dashboard
The four operating signals from this brief’s dashboard, each tied to the candidate owner named in the executive scorecard, around one accountable route. Drawn from the page’s original executive guidance.
Data note. Structural diagram; no measured values.
Limitation. Owners are candidates to be confirmed locally.
Figure data (4 rows)
| Operating signal | Candidate owner |
|---|---|
| Message alignment | Executive sponsor and operational lead |
| Response ownership | Operational owner and participating teams |
| Navigation and communication | Sending and receiving owners |
| Action closure | Improvement owner and executive sponsor |
Executive guidance · Handoff workflow
Close the loop across teams, settings, and partners.
A handoff is reliable only when the sending party knows who is expected to receive the work, the receiving party acknowledges responsibility, and any unresolved exception remains visible. Local policy and qualified judgment control the actual process.
How responsibility moves
Lane A
From message to accepted ownership
- Confirm the approved message and intended audience.
- Publish the actual entry point and receiving role.
- Acknowledge receipt using the locally approved method.
- Escalate when ownership or response remains unclear.
Lane B
From accepted ownership to verified follow-through
- Record the next accountable owner and visible status.
- State the next owner, approved communication channel, and unresolved status in a form the receiving team can use.
- Keep unresolved work visible across boundaries.
- Confirm closure or document the continuing exception.
Executive guidance · Executive scorecard
Give leaders one view of route reliability and improvement.
The scorecard keeps review focused on decisions. Leaders should set definitions locally, examine variation without overclaiming cause, and pair quantitative signals with the experience of people who use and operate the route.
Who reviews what
- Executive sponsor and operational lead
- Operational owner and participating teams
- Sending and receiving owners
- Improvement owner and executive sponsor
Candidate owners named in the scorecard, confirmed locally.
| Operating signal | Executive question | Candidate owner | Suggested review point |
|---|---|---|---|
| Message alignment | Do channels and partners communicate one current and appropriately bounded route? | Executive sponsor and operational lead | At campaign launch and close |
| Response ownership | Does every campaign-generated request reach an accountable receiver? | Operational owner and participating teams | At a locally defined cadence |
| Navigation and communication | Can people and support networks understand who owns the next step and how to raise an unresolved barrier? | Sending and receiving owners | At a locally defined cadence |
| Action closure | Did leaders complete and verify the improvement selected for the campaign window? | Improvement owner and executive sponsor | Until action is verified |
Figure 5
Control points for coordinated dementia care
| Control point | Risk if missing | Owner | Evidence of control |
|---|---|---|---|
| Brief, language-adapted cognitive screen built into the routine visit workflow | Cognitive change goes unrecognized, especially in non-White populations | Chief medical officer with primary care medical director | Screening completion and new diagnoses among patients screening positive, by language and race |
| Clear referral pathway from primary care to specialist assessment | Families must assert candidacy repeatedly and diagnosis stalls | Ambulatory operations lead and neurology or geriatrics lead | Time from documented concern to specialist assessment |
| Continuous case management after diagnosis | People dismissed from follow-up have higher symptom and distress scores | Director of care management | Share of newly diagnosed patients with active follow-up at one year |
| Named owner for each medication task at hospital-to-home-health transition | Role ambiguity leads to medication errors and adverse events | Hospital medicine lead and home health agency director | Primary care notified after discharge and medication reconciliation documented at first home visit |
| Dementia training for home care and home health staff with outcome tracking | Knowledge rises but emergency visits and hospitalizations do not change | Chief nursing officer and workforce development lead | Competence measures paired with client utilization and cost reporting |
| Anticipatory guidance and timely hospice referral | Families meet end of life without information or coordination | Palliative care lead | Share of decedents with dementia referred to hospice and with a documented guidance conversation |
Control points derived from the cited evidence [1], [4], [8], [9], [14], [15] and this brief’s executive guidance.
Data note. Each row is a control to verify, not a measured result.
Limitation. Owners and evidence of control must follow local policy and applicable requirements.
Public communication
Helping people raise concerns and know what comes next
Public communication during World Alzheimer’s Month can strengthen the first step of the continuum. Researchers recommended raising community awareness of dementia symptoms to help people communicate their concerns effectively with their primary care physician.[4] A campaign that teaches people what to say, and where to say it, supports the candidacy that interviewees described as decisive. The same study recommended clear diagnostic pathways, so that people who raise concerns receive the appropriate diagnosis and care.[4]
Messaging must work against normalization and stigma. The meta-synthesis listed stigma, denial and symptom normalization among patient-level barriers, and dementia literacy campaigns among facilitators.[3] Messages that distinguish dementia from ordinary aging address a barrier that appeared across countries.[3][7] In the Philippines, local terms that frame dementia as aging show how everyday language can make memory loss seem normal.[7]
Communication about what lies ahead matters to families. Caregivers in the Care Ecosystem trial asked for more anticipatory guidance and more information about hospice care.[8] Public materials and care plans can share the typical stages of support, the services available at each stage and the contact who coordinates them. Care navigation raised caregiver self-efficacy, even though satisfaction with end-of-life care did not differ from usual care.[8]
New diagnostic tests require careful public framing. Plasma biomarker testing was reported by only 16% of primary care providers in the national survey, and the authors called for guidelines to inform their decisions.[2] Public messages should not imply that new tests are routinely available or that they replace a clinical evaluation. Plain language about what a test can and cannot show protects trust as these tools spread into primary care.
Finally, communication inside the system matters as much as outreach. Australian general practitioners were described as delaying conversations about dementia, and family concern often triggered investigation.[5] When families raise a concern, the system’s reply should be prompt, consistent and documented. Measuring how often concerns lead to an assessment is a direct test of whether public messaging is matched by service. Internal messages between primary care, home health and hospital teams should also name the owner of each next step. Clear ownership of medication tasks after discharge was a central theme of home health improvement work.[14]
Executive guidance · 90-day plan
Turn the observance into one sustained operating change.
The time boxes below are a management framework, not a clinical timeline. Adjust them to risk, scope, governance, resources, stakeholder participation, and applicable review requirements.
Ninety days, three moves
- Days 1–30See the current route
- Days 31–60Build the reliable path
- Days 61–90Make the change visible
Days 1–30 · Listen and map
See the current route
- Name an executive sponsor and an operational owner.
- Listen to people using the route and representative frontline teams.
- Map how World Alzheimer’s Month communications connect to real entry points, owners, transitions, and escalation.
- Select one recurring barrier that the organization can responsibly address.
Days 31–60 · Design and test
Build the reliable path
- Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal.
- Validate the design with every sending and receiving team involved.
- Validate one complex navigation handoff with people using and operating the route, then correct a barrier.
- Test the route in more than one representative setting or operating period where practical.
Days 61–90 · Implement and verify
Make the change visible
- Launch the redesigned route with a small set of locally defined measures.
- Review unresolved work and recurring friction using a learning approach.
- Correct implementation barriers and record who owns each remaining dependency.
- Report what changed, what evidence was reviewed, and what still requires live oversight.
Figure 6
The 90-day plan on one timeline
The 90-day plan from this brief drawn as a timeline: each action sits in the 30-day window the plan assigns it. The full wording of each action is in the figure data and in the plan above.
Data note. Time boxes are a management framework, not a clinical timeline.
Limitation. Durations are uniform 30-day windows; real tasks may span windows.
Figure data (12 rows)
| Window | Action |
|---|---|
| Days 1–30 · Listen and map | Name an executive sponsor and an operational owner. |
| Days 1–30 · Listen and map | Listen to people using the route and representative frontline teams. |
| Days 1–30 · Listen and map | Map how World Alzheimer’s Month communications connect to real entry points, owners, transitions, and escalation. |
| Days 1–30 · Listen and map | Select one recurring barrier that the organization can responsibly address. |
| Days 31–60 · Design and test | Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal. |
| Days 31–60 · Design and test | Validate the design with every sending and receiving team involved. |
| Days 31–60 · Design and test | Validate one complex navigation handoff with people using and operating the route, then correct a barrier. |
| Days 31–60 · Design and test | Test the route in more than one representative setting or operating period where practical. |
| Days 61–90 · Implement and verify | Launch the redesigned route with a small set of locally defined measures. |
| Days 61–90 · Implement and verify | Review unresolved work and recurring friction using a learning approach. |
| Days 61–90 · Implement and verify | Correct implementation barriers and record who owns each remaining dependency. |
| Days 61–90 · Implement and verify | Report what changed, what evidence was reviewed, and what still requires live oversight. |
Executive guidance · Leadership close
Make World Alzheimer’s Month a starting point, not an endpoint.
Recognition matters. It becomes durable when leaders also listen, clarify the route, support the people operating it, close an identified gap, and report the result without claiming more than the evidence supports.
Leadership commitment
Make ownership visible, test the route, and report what improved.
Executive action kit · Month observance
Turn World Alzheimer’s Month into accountable action.
An executive-guidance framework for coordinated messaging, visible ownership, and a measured improvement cycle.
Leadership focus
Use this observance to examine navigation, longitudinal ownership, and specialty-care coordination. Select one verified barrier, assign an accountable owner, and carry the improvement beyond the campaign window.
Workforce lens
Ask whether staffing, role clarity, training, tools, workload, and escalation support the people operating the information, assessment navigation, support, and longitudinal follow-through pathway.
Patient and community lens
Make the approved first step clear. Test whether a person can move from information to an acknowledged next action without navigating conflicting instructions.
Equity and access lens
Review communication access, cognitive accessibility, caregiver burden, transportation, digital access, and geographic availability.
Five-minute briefing
Inspect the operating sequence
Listen with people using the pathway, caregivers, clinical teams, rehabilitation, and community supports. Find one fragmented information, a failed transition, or an unresolved support need, then test the locally approved route from entry through acknowledged follow-through.
- Define the purpose
- Align the entry point
- Support complex navigation
- Manage response
- Review the campaign
Leadership actions for this week
- Name an executive sponsor and frontline operating owner.
- Ask people using and operating the pathway where ownership becomes unclear.
- Test one representative route from first question to acknowledged next step.
- Select one barrier that can be corrected without overstating the evidence.
- Set a review date and define how completion will be verified.
Candidate measures
Define every numerator, denominator where relevant, owner, data source, exclusions, cadence, and limitation locally. These are management prompts, not external benchmarks.
- Content review status, conflicting instructions, corrections, and unresolved questions.
- Routing, acknowledgment, repeat contact, unresolved work, and escalation signals.
- Locally defined communication barriers, repeated contacts, transition acceptance, support requests, and route completion.
Department readiness checklist
- The public and staff entry points match the actual approved process.
- A specific role accepts each request, referral, or escalation.
- Handoffs include acknowledgment and a visible unresolved state.
- Language, disability, digital, transportation, and trust barriers receive explicit review.
- Communications do not introduce unsupported themes, statistics, or clinical advice.
- A named leader will review what changed after the observance.
Intended audiences
- Executive and Operational Leaders
- Patient Experience and Access Leaders
Staff communication template
During World Alzheimer’s Month, our organization will connect awareness with a practical review of the information, assessment navigation, support, and longitudinal follow-through pathway. Use approved information, identify the correct entry point, confirm ownership when work moves, protect privacy, and escalate unresolved barriers through local channels.
Community communication template
World Alzheimer’s Month is an opportunity to share trustworthy information and make the next step easier to find. Use our approved channels for information and support. If a request changes hands, our goal is to keep ownership and follow-through visible.
Measurement worksheet
- Signal
- What observable condition will show whether the route works?
- Definition
- What is included, excluded, and counted?
- Owner
- Who reviews the signal and acts on exceptions?
- Cadence
- When will leaders review it?
- Equity check
- Which differences require protected, locally appropriate review?
- Closure
- What evidence will confirm the improvement was completed?
- Editorial review
- Completed
- Source records
- 2 listed under Authoritative resources
- Review standard
- Sourced facts remain separated from original executive guidance
- Clinical boundary
- No new statistical or clinical claim was added by this action kit
Sources and content boundary
Authoritative resources
Use note: All operating models, measures, scorecard questions, and action steps are original executive guidance. This article supports leadership planning and education. It does not replace clinical judgment, emergency procedures, legal advice, professional standards, organizational policy, or applicable federal, state, and local requirements.
Peer-reviewed references
References
Fifteen peer-reviewed sources, newest first. Each was individually verified through authenticated academic research databases. Bracketed numbers in the text link here; the original executive guidance on this page carries no citations because it is guidance, not a sourced claim. Sources last checked in those databases on .
- 1.Shah S, Tran T, Wadhwa SS, Huerta GI, Ovalle-Eliseo S, Martinez A, et al. Increased dementia diagnosis and workup in primary care with a bilingual screening tool integrated in the electronic health record. Journal of Alzheimer’s Disease. 2026;111(3):1291-1300. https://doi.org/10.1177/13872877261441776
- 2.Couch E, Gantenberg JR, Belanger E. Adoption of Alzheimer’s disease biomarkers by primary care clinicians: findings from the National Dementia Workforce Study. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2026;22(7):e71665. https://doi.org/10.1002/alz.71665
- 3.Juanamasta IG, Polsook R, Ahmed B, Aungsuroch Y, Dewi NMRC, Suparta IGG, et al. Navigating the Threshold: Barriers and Facilitators to Accessing Primary Care Among People Living with Dementia-A Systematic Review and Meta-Synthesis. International Journal of Environmental Research and Public Health. 2026;23(8). https://doi.org/10.3390/ijerph23081031
- 4.Gulline H, Carmody S, Bevins A, Yates M, Daly S, Pond D, et al. Primary care determinants for timely diagnosis of dementia. Family Medicine and Community Health. 2026;14(4). https://doi.org/10.1136/fmch-2026-004039
- 5.Low LF, Gibson C, Barcenilla-Wong A, Daniel S, Phillipson L, Gresham M, et al. How does Australian primary care face dementia? Identifying current practice and barriers in dementia diagnosis and management in Australian primary care - a qualitative interview study. BMC Primary Care. 2026;27(1). https://doi.org/10.1186/s12875-026-03275-9
- 6.Yates M, Gibson C, Pond CD, Daly S, Jebramek J, Daniel S, et al. Facing Dementia in Primary Care: A Process Evaluation of a Multicomponent Practice Change Intervention to Improve Dementia Diagnosis in General Practice. International Journal of Environmental Research and Public Health. 2026;23(8). https://doi.org/10.3390/ijerph23081086
- 7.Amamanglon KPH, Chu DM. Knowledge, attitudes, and practices of primary care physicians regarding dementia diagnosis and management in the Philippines: A national cross-sectional survey. Neurology Asia. 2026;31(3):1131-1153. https://doi.org/10.54029/2026tem
- 8.Hunt LJ, Harrison KL, Kiekhofer R, Merrilees J, Sideman AB, Dulaney S, et al. The Effect of the Care Ecosystem Collaborative Care Model on End-of-Life Outcomes for People With Dementia and Their Caregivers. American Journal of Hospice & Palliative Medicine. 2026;43(9):920-931. https://doi.org/10.1177/10499091251367311
- 9.Hung Y, Wang W, Chang M, Tung Y, Jhang K. Association of Participation in the Collaborative Care Team With Behavioral and Psychological Symptoms of Dementia and Caregiver Distress. Brain & Behavior. 2026;16(8):1-10. https://doi.org/10.1002/brb3.71694
- 10.Thissen S, Sizoo E, Smalbrugge M, Gerritsen DL, Perry M. From bubbling to boiling over: a meta-ethnography of the process towards and during crisis from the perspectives of persons living with dementia, informal carers and healthcare professionals. Age & Ageing. 2026;55(1):1-15. https://doi.org/10.1093/ageing/afaf383
- 11.Li Q, Zhang D, Quinn É, Walsh PK, Hynes DS. Online interventions for dementia caregiver burden and self-efficacy: A systematic review and meta-analysis. International Journal of Nursing Studies Advances. 2026;10. https://doi.org/10.1016/j.ijnsa.2026.100490
- 12.Li Y, Menon G, Long JJ, Kim B, Bae S, Orandi BJ, et al. Neighborhood Disadvantage and Dementia Risk Among Older Patients With Kidney Failure: Differences by Race/Ethnicity and Urbanicity. Kidney Medicine. 2026;8(10). https://doi.org/10.1016/j.xkme.2026.101479
- 13.Belay YB, Goh A, Dow B, Dang C, Savvas S, Batchelor F, et al. Cost-Consequence Analysis of a Dementia Specialist Training Program for Home Care Workers: Results From a Stepped-Wedge Cluster-Randomised Controlled Trial. Australasian Journal on Ageing. 2026;45(4):e70239. https://doi.org/10.1111/ajag.70239
- 14.Cai CY, Greyson S, Fakeye MK, Sharma R, Keller S, Gurses AP, et al. Practical strategies for improving medication management during care transitions for older adults with dementia: findings from a novel stakeholder-informed review process. Age & Ageing. 2025;54(10):1-9. https://doi.org/10.1093/ageing/afaf277
- 15.Yeh J, Beld M, Pond B, Neri M, Garcia A, Mata-Pacheco J, et al. Competency-based training boosts dementia knowledge and skills in home care workers. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2025;21(6):e70323. https://doi.org/10.1002/alz.70323
Claim-to-source matrix
What each source supports
Every sourced claim in the new sections maps to the references that support it, the section where it is used, and the limitation a reader should keep in mind. Original executive guidance carries no sources because it is guidance, not a finding.
| Claim group | Sources | Years | Used in | Limitation |
|---|---|---|---|---|
| EHR-embedded bilingual screening and new dementia diagnoses | [1] | 2026 | Current evidence | Single-clinic pre-post design; the post-period rate is reported among patients who screened positive. |
| Biomarker adoption by primary care providers | [2] | 2026 | Current evidence | Self-reported use in 2024, the year after Medicare expanded coverage for some biomarkers. |
| Barriers and facilitators to primary care access | [3] [4] [5] | 2026 | Access | Largely qualitative evidence; Australian interview samples of 37 and 18 participants. |
| Practice change program reach and risk-alert uptake | [6] | 2026 | Access | Process evaluation of one Australian program; no outcome effect reported. |
| Collaborative care, continuity and caregiver distress | [8] [9] | 2026 | Current evidence | Retrospective cohort for continuity findings; trial outcomes limited to end-of-life measures. |
| Online caregiver interventions | [11] | 2026 | Current evidence | Low evidence grade due to risk of bias, inconsistency and imprecision. |
| Home care workforce training effects and costs | [13] [15] | 2026, 2025 | Human infrastructure | Quasi-experimental design in one program; economic analysis secondary to the main trial outcome. |
| Medication management and crisis during transitions | [10] [14] | 2026, 2025 | Continuum of care | Stakeholder-informed strategy development with 14 members; qualitative synthesis of 19 studies. |
| Neighborhood disadvantage, race and dementia risk | [12] | 2026 | Equity and trust | Dialysis population only; ZIP codes used as a proxy for neighborhoods; diagnosis codes as outcome. |
| Primary care physician knowledge and training needs in an LMIC | [7] | 2026 | Human infrastructure | Online survey of 275 respondents; knowledge checklist had low internal consistency. |
About the author
Greg Wahlstrom
MBAHCM
President and Chief Executive Officer, The Healthcare Executive
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