Imagining dementia care in 2055: scenarios for policy-informed foresight in the Netherlands

Abstract

As populations age, dementia prevalence is set to rise sharply, placing even more pressure on already strained care systems. Understanding how these systems might evolve is urgent, yet the future is deeply uncertain. Equally important is ensuring that insights about these futures reach and resonate with the full range of people who shape and experience care. Within this study two scenarios for dementia care in the Netherlands in 2055 were developed. The main aim was to create scenarios compelling to a broad and diverse audience, including clinicians, policymakers, researchers, care professionals, and the wider public, using one high- and one low-tech approach. The two morphological scenarios were developed based on critical uncertainties extracted from a newly developed causal loop diagram (CLD) for dementia care. The CLD surfaced two central bottlenecks locked in a reinforcing feedback loop: the high burden on formal and informal caregivers and unmet care needs. In the Caring Communities scenario, dementia-friendly neighborhoods form the backbone of care, supported by an active government and modest technology. In the Technological Transformation scenario, care scales through AI, robotics, and market-driven innovation, with professionals shifting from hands-on care to coordination and oversight. To bring these futures to life across different audiences and skill levels, the scenarios were translated into two complementary formats. One high-tech approach was developed, using scenario videos to vividly portray each future world. The low-tech approach used storytelling to invite stakeholders to explore and debate the scenarios through narrative. The study showed that by making the scenarios compelling to a broad audience, abstract and systemic futures were made tangible, debatable, and actionable. This equipping experts, policymakers, and citizens with a shared imaginative foundation for navigating the future of dementia care.