Day Centers to Improve Care and Rehabilitation for People with Dementia

At GAMA, a day center in Mar del Plata, Argentina, a man sat down at the piano and began playing a tango. His partner recognized the “maestro” and tearfully explained that he had not played in more than three years. He had once been an accomplished pianist and orchestra conductor, but had been living with dementia for some time. From that day on, he and the center’s music therapist formed an orchestra and began meeting to play tango music. Experiences like this show how day centers can help people with dementia maintain autonomy and quality of life while restoring a sense of purpose, connection, and dignity.

People in Latin America and the Caribbean are living much longer. As they age, their risk of dementia increases. Dementia is one of the leading causes of disability and care dependence. An estimated 4.5 million people in the region live with dementia, and that number is expected to reach 13.6 million by 2050.

People with dementia often want something simple: to grow older in their own homes and communities and remain as independent as possible, even as they come to need more support. Today, families provide most of the care in the region, often with little training and few opportunities for respite. Day centers offer a practical way to meet these needs.

This was the focus of a webinar organized by the Inter-American Development Bank (IDB) together with Alzheimer’s Disease International, the international federation of Alzheimer’s and dementia associations around the world, and the Economic Commission for Latin America and the Caribbean (ECLAC), which featured experiences from Argentina and Japan.

Japan: Integrating Dementia Care into Long-Term Care

Japan has integrated day centers into the backbone of its national long-term care policy. Since 2000, mandatory long-term care insurance has been in place for people over age 40. It covers two types of centers: one providing everyday support—meals, personal hygiene, and health monitoring—and another that also offers rehabilitation and basic medical care. Users pay between 10% and 30% of the cost. By 2024, the country had approximately 100,000 centers serving more than 4 million users.

With nearly 6 million people living with dementia, Japan has integrated dementia care as a core component of services for older people.

What stands out is the emphasis on dignity, autonomy, and purpose. For example, at a day center in the Japanese city of Yokosuka, people with dementia go to nearby parks to sweep leaves, mow lawns, water flowers, and clean playgrounds. Their activities include both paid and volunteer work: they receive wages for the work they do, and although the amount is small, it is meaningful because it gives them a sense of social inclusion and purpose.

Argentina: A Community-Based Response

In Argentina, GAMA is a nongovernmental organization that emerged 35 years ago from a training and information course for families of people with dementia. At the end of the course, families asked, “What now?” In response to that need, a support group was formed, which over time gave rise to new services for people with dementia and their families.

In 2005, GAMA opened a building designed around the social model of disability, which considers space as an enabler for functionality and autonomy, with its three floors organized according to the stage of dementia. People who attend the day center stay for five hours, between two and five times a week. Groups have a maximum of 15 people and are organized according to participants’ needs and level of impairment.

Nonpharmacological treatments are provided daily, combining neurocognitive rehabilitation, physical stimulation, and social contact to maintain autonomy and delay dependency. Funding comes from out-of-pocket payments, donors, insurers, and grants. The monthly cost is approximately US$350, and 10% of users attend free of charge based on their socioeconomic circumstances.

Participants report improved mood, broader social connections, and fewer medical visits. The model delays—and sometimes prevents—institutionalization, strengthens family relationships, and improves primary family caregivers’ capacity to cope. The GAMA model takes a comprehensive approach to dementia: it supports both the person with dementia and their primary family caregiver, providing emotional support, active listening, and guidance.