**2.1. Policy environment**

The latest 'Economic Impact of Dementia' report authored by Deloitte [23] and commissioned by Alzheimers New Zealand, suggests there will be approximately 170,000 New Zealanders living with dementia by 2050, up around 300 percent on current figures of 62,000. The report highlights the significant economic impact of dementia with the costs of supporting dementia diagnosed people could reach nearly \$5 billion by 2050. It is suggested that new models of care that delay entry into residential care have the potential net benefit of \$22 million a month, leading to substantial savings over time. The economic impact report is a key information source on the size and scale of the dementia challenge in New Zealand and is used to inform decision-making around dementia policy [23].

The New Zealand policy framework for senior home-based support is primarily founded upon two Government strategy documents: the Ministry of Social Development's New Zealand 'Positive Ageing Strategy, 2001' and the Ministry of Health's 'Health of Older People Strategy, 2002'. The Positive Ageing Strategy promotes the concept of positive ageing, affirms the value of older members of society, and highlights the importance of issues such as access to health services, financial security, independent living, the physical environment and personal safety. The Health of Older People Strategy details an integrated continuum of care, which seeks to ensure that all relevant health and disability services are coordinated in such a way that older peoples' needs are appropriately met "at the right time, in the right place and from the right provider" [24].

In recognition of the increasing challenge of burgeoning numbers of older adults diagnosed with dementia, the New Zealand Ministry of Health released in 2013 the 'New Zealand Dementia Care Framework' to initiate and coordinate dementia services for people living with dementia in the caregivers/families [25].

The vision of the framework is to ensure: people living with dementia, their family are valued partners in an integrated health and support system. They are supported throughout their journey with dementia, to enable them to maintain and maximise their abilities, optimise their sense of well-being and have control over their circumstances [25]. While the national framework recognises that many individuals living with dementia may ultimately require residential care facilities, the framework actively promotes community-based services that support those individuals living with dementia to remain living at home and home-based support services are a central component of this approach. The Framework is not directly based upon the restorative model of care, it does advocate for a person-centred and people directed approach that includes many restorative like principles ensuring that people living with dementia and the families/caregivers are respected, valued and are engaged partners in care planning, receive clear communications and education that enable them to be engaged at all levels of decision-making, and able to self-determine many aspects of their lives [25].
