Ontario is Taking Dementia Seriously: Let's Hope They Get It Right

Ontario has recently introduced several pieces of legislation that signal a commitment to improving dementia care across the province. The most recent addition is the Improving Dementia Care in Ontario Act, 2024, S.O. 2024, c. 32 — Bill 121, which received Royal Assent on December 19, 2024. Alongside Bill 235, the Support for Seniors and Caregivers Act, 2024, these laws suggest that Ontario is beginning to take dementia seriously. But the real question is: will they get it right?

Bill 121: A Provincial Framework for Dementia Care

The Improving Dementia Care in Ontario Act, 2024 requires Ontario's Minister of Health to develop a framework "designed to support improved access to dementia care, provided through hospitals, home care, long-term care homes, hospices and community care services, that, among other things,

(a)  promotes person-centred dementia care;

(b)  defines what person-centred dementia care is;

(c)  identifies the person-centred dementia care training and education needs of health care providers as well as other caregivers;

(d)  identifies measures to support dementia care providers;

(e)  identifies research and common data elements on dementia care;

(f)  identifies measures to facilitate equitable access to dementia care across Ontario, including strategies to increase awareness of programs such as the First Link program offered through the Alzheimer Society of Ontario;

(g)  identifies measures to facilitate consistent access to dementia care across Ontario;

(h)  takes into consideration existing dementia care frameworks, strategies and best practices;

(i)  reviews Quality Health Ontario’s Quality Standard entitled “Dementia: Care for People Living in the Community”;

(j)  takes into consideration and supports the needs of specific patient populations, including women, francophone and those diagnosed with early onset Alzheimer’s dementia; and

(k)  leverages the expertise and capacities of other key partners in Ontario’s health system, such as the Ministry of Long-Term Care, Ministry for Seniors and Accessibility, Ministry of Colleges and Universities, The Alzheimer’s Society of Ontario, the Ontario Brain Institute, Ontario Health, Ontario Health Teams and other providers and organizations."

This new law also requires a review of the  “Personal Support Worker Standard” to assess if changes should be made to require more dementia-specific learning and training. Regrettably, the law only requires a review rather than mandatory enhancements to the training.

Bill 235: Building on Existing Commitments

The provincial government’s commitment to dementia care is also evident in Bill 235, which requires every long-term care home to establish an organized program of dementia care and services. This complements Bill 121’s broader framework by mandating actionable programs within long-term care settings. Bill 235 is not yet law, but is well on its way.

Why Meaningful Implementation Matters

While these legislative efforts are promising, their success hinges on meaningful implementation. Effective dementia care must go beyond checking boxes or adopting generic training modules. For instance:

• Customizing care plans: Dementia is not a one-size-fits-all condition. Different types, such as Alzheimer’s disease, vascular dementia, and Lewy body dementia, require distinct approaches to care.
• Behavioral strategies: Training must include techniques for interpreting and responding to common expressions of distress, such as “I want to go home” or “Where is my mother?” These are often manifestations of unmet needs that require empathetic, informed responses.
• Professional expertise: The development and delivery of training programs must involve dementia care specialists who understand the nuances of the condition and can provide practical, evidence-based guidance.

A Holistic Vision for Dementia Care

Taken together, Bill 121 and Bill 235 represent a holistic vision for dementia care that spans the continuum of care settings—from home care and hospitals to long-term care homes and community services. By addressing training, equity, and person-centred approaches, these laws aim to transform how dementia care is delivered in Ontario. Given the prediction that 1 million Ontarians will have dementia by 2030, it is critical that this vision be translated from words to action.

The Stakes for Families

For families navigating the complexities of dementia care, these legislative changes could be life-changing—if done right. Many caregivers worry about whether their loved ones are receiving the best possible care, particularly in long-term care settings. Bills 121 and 235, if implemented with care and diligence, have the potential to alleviate these concerns by raising the standard of dementia care across the province.

Final Thoughts

Ontario’s recent legislative efforts indicate a serious commitment to improving dementia care, but the true impact will depend on how well these laws are implemented. Robust training, meaningful programs, and continuous evaluation will be critical to ensuring that the promises of Bills 121 and 235 translate into real improvements for individuals living with dementia and their families.