Alfredo de Andrade is a success story of the national Specialist Dementia Care Program (SDCP) that provides support for the estimated one per cent of people living with dementia with very severe behaviours and psychological symptoms.
New research on the SDCP, published in Australasian Journal on Ageing, has found “limited yet promising evidence” that the SDCP units now operating around the nation are enhancing resident outcomes with some individuals transitioning to mainstream care.
Portuguese-born Alfredo, 79, received the help he needed to stabilise his aggression and restlessness at Quintral cottage, an SDCP unit located at HammondCare Cardiff. So effective, Alfredo returned to regular aged care.
Each SDCP unit provides person-centred care, in small, cottage like surroundings without restraints. Multidisciplinary teams work alongside government services and Dementia Support Australia (DSA).
There are presently 19 SDCP units, like Cardiff, around Australia managed by a range of providers. Another six SDCP units will open later this year with Department of Health, Disability and Ageing aiming for 35 nationally.
Alfredo’s son Paulo de Andrade said the SDCP provided his dad with the help he needed at a vulnerable stage of life.
“The care he has been given there has certainly been special – it was a safe environment for him,” he said.
Alfredo died on Sunday, June 1, 2025, Paulo said his family were appreciative he did so with quality of life.
Allco Steel, eager for Alfredo’s boilermaker skills, sponsored Alfredo to migrate from Portugal to Newcastle in 1981, along with wife Maria and three children, to their Tomago plant. The family settled in Metford.
As a metal worker, Alfredo fabricated the steel for high-profile projects such as the Australian Maritime Museum, Darling Harbour, Chifley Tower and even the Sydney monorail. These achievements made him and his family proud.
Outside work, his family and his love of football club Benefica Lisbon were his obsessions, although Alfredo was always limited in his English skills.
About 10 years ago after retiring, Alfredo was diagnosed with vascular dementia. A fall, resulting in fractures in 2017, accelerated his decline.
In 2023, Alfredo was admitted to Maitland Hospital for what became a harrowing eight-month stay. He experienced fresh fractures, more falls, delirium, COVID-19 and strokes and struggled to sleep.
There were Code Black incidents from Behaviours and Psychological Symptoms of Dementia (BPSD), made worse by language barriers. A special nurse supported his safety and the safety others. No aged care home would take him.
He was referred to DSA for a suitability assessment for a place in the 8-bed Quintral Cottage. He transferred on December 17, 2023. There was agreement with family on a care plan to reduce antipsychotic medication that had side effects like restlessness and falls. There was also a need to address unmanaged pain behind behaviours.
More than a year later, Alfredo moved out of Quintral cottage into a stepdown cottage. HammondCare SDCP Manager Pratikshya Shrestha said he “added a lot of joy to the cottage” and enjoyed his gardening in the months before his death.
Paulo can’t speak highly enough of the staff, led by Residential Manager Laiju Benny.
“Once he got off those drugs he stabilised and his aggression disappeared,” he said. “In his final years of life, he is comfortable.”
The research, “The Specialist Dementia Care Program in Australia: Evidence to date on a home-like model of care for people with very severe behaviours and psychological symptoms of dementia”, assessed the model of care and available evidence on SDCP outcomes.
Researchers Mustafa Atee, Srivalli Vilapakkam Nagarajan, Rebecca Lloyd, Stephen Macfarlane, Angela Raguz and Thomas Morris wrote that SDCP could play a crucial role in addressing systemic challenges in dementia care, “particularly in the role of reducing hospital bed block associated with a lack of suitable care options for people experiencing very severe BPSD”.
They wrote that the preliminary evidence suggests SDCP units, and their features, may enhance resident outcomes, decrease severity of BPSD, facilitate successful transitions into mainstream residential aged care, reduce reliance on psychotropic medications and improve quality of life.