Understanding the Dementia Care Triad: Findings From a Longitudinal Qualitative Study With People Living With Dementia, Their Carers, and Their Healthcare Professionals

Tuijt, R, Manthorpe, J, Rait, G, Frost, R ORCID: 0000-0003-3523-0052, Wilcock, J and Walters, K (2025) Understanding the Dementia Care Triad: Findings From a Longitudinal Qualitative Study With People Living With Dementia, Their Carers, and Their Healthcare Professionals. Dementia, 25 (6). pp. 1229-1247. ISSN 1471-3012

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Abstract

Background: Best healthcare practice for people with dementia encourages the inclusion of family members or carers, alongside enabling people with dementia to make their own decisions. Dementia care thus often includes the person with dementia, their carer, and their healthcare professional (HCP): a dementia care triad. Understanding how this triad is developed and navigated may improve future dementia care services. Methods: A longitudinal qualitative approach was used to interview 30 people with dementia, 31 family carers, and 7 healthcare professionals in England between May 2020 and March 2021. Data from three interview time points were transcribed and analysed using reflexive thematic analysis. Findings: The relationships within a dementia care triad were initially built on the dyadic relationship between the person with dementia and their family carer and any pre-existing relationships with their HCP. The nature and proximity of the carer to the person with dementia influenced how triadic relationships in dementia care formed and functioned, with spousal and co-resident carers more actively involved in healthcare interactions. Further positive development of a triad required confidence in the HCP, and shared perspectives on balancing the involvement of the carer and the independence of the person with dementia, with considerations of autonomy and risk, and which did not always follow a linear transition. While increased carer involvement often supported the person with dementia, it sometimes led to their exclusion. Engagement by healthcare professionals varied, reflecting inconsistencies in applying person-centred care. Conclusions: The findings of this study suggest a need for clearer, more consistent approaches that support dynamic carer roles while preserving the autonomy of the person with dementia. This study provides additional considerations in relationship dynamics that inform our understanding of the dementia care triad.

Item Type:	Article
Uncontrolled Keywords:	dementia; qualitative; healthcare; care network; longitudinal; relationships; Humans; Dementia; Longitudinal Studies; Qualitative Research; Aged; Aged, 80 and over; Middle Aged; Caregivers; Health Personnel; England; Female; Male; care network; dementia; healthcare; longitudinal; qualitative; relationships; Humans; Dementia; Caregivers; Longitudinal Studies; Qualitative Research; Male; Female; Health Personnel; Aged; England; Middle Aged; Aged, 80 and over; 4203 Health Services and Systems; 4205 Nursing; 42 Health Sciences; Neurodegenerative; Brain Disorders; Dementia; Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD); Alzheimer's Disease; Acquired Cognitive Impairment; Neurosciences; Aging; 7.1 Individual care needs; 8.1 Organisation and delivery of services; Neurological; 3 Good Health and Well Being; Humans; Dementia; Caregivers; Longitudinal Studies; Qualitative Research; Male; Female; Health Personnel; Aged; England; Middle Aged; Aged, 80 and over; 1103 Clinical Sciences; 1110 Nursing; 1702 Cognitive Sciences; Geriatrics; 4203 Health services and systems; 4205 Nursing
Subjects:	H Social Sciences > HT Communities. Classes. Races R Medicine > RT Nursing
Divisions:	Nursing, Public and Allied Health
Publisher:	SAGE
Date of acceptance:	5 August 2025
Date of first compliant Open Access:	21 September 2026
Date Deposited:	21 Sep 2026 13:39
Last Modified:	21 Sep 2026 13:39
DOI or ID number:	10.1177/14713012251372224
URI:	https://researchonline.ljmu.ac.uk/id/eprint/29484

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