The Portuguese National Health Plan for Dementia has had a new governance model since April 2026. At the time it was read as an administrative reshuffle: the Executive Board of the National Health Service now coordinates delivery, after the regional health administrations were wound up. Anyone working in a care home or a convalescence unit shrugged, and with apparent reason — the org chart changed, Thursday afternoon did not.
The part that matters is not who coordinates. It is what is now counted.
The indicators
The order sets evaluation indicators for the implementation of care pathways in local health units. Among them:
- the number of integrated care pathways actually implemented;
- the share of health professionals with specific training in dementia;
- the support provided to informal carers;
- individual care plans, plus service indicators such as admissions, emergency attendances and referral to continuing and palliative care.
The second and third are worth pausing on. A national plan that measures staff training and carer support is saying, in the language of indicators, that care for a person with dementia is not settled by a drug and an appointment. It is settled by prepared people and by the family alongside.
What it changes for an institution
None of this obliges a private institution, a care home or a non-profit to do anything. The order binds the NHS. But the indicators of a national plan have a habit of trickling down: they show up later in tender documents, in funding applications, in monitoring visits and in conversations with the local health unit.
If the question "how many of your staff have specific dementia training?" is going to be asked of somebody, it is better to have the number.
Counting before you are asked is cheap. Counting afterwards is a meeting.
Where a non-pharmacological tool fits
Honestly: not in the indicators. None of them measures equipment, and that is as it should be — a plan that counted devices purchased would be measuring budget, not care.
It fits somewhere else, which is more interesting. Two of the indicators — team training and informal carer support — describe work done by people. Any tool, whether a virtual reality system, a Snoezelen room or an activity trolley, only counts if the team knows how to use it and if a record of what happened reaches the patient's file. Equipment on its own produces none of these numbers.
It is the same conclusion we reached elsewhere, writing about what the health system measures and what stays invisible: what is not recorded does not exist for whoever evaluates it, however well it went.
Three things to do this week
- Count who has training. Not "the team is aware of it" — how many people, what training, what year.
- Look at how contact with the informal carer is recorded. In a notebook, it does not count. In the file, it counts.
- Call the local health unit and ask whether it already has an integrated dementia pathway, and who the contact is. It is one phone call.
None of the three needs budget, and none needs technology. They are the ones that decide whether the fourth — buying anything at all — makes any sense.
Sources: Order approving the new governance model of the National Health Plan for Dementia, published 13 April 2026; National Dementia Plan, Alzheimer Portugal.