About 70,000 New Zealanders are living with dementia - an umbrella term for a variety of neurological illnesses that affect memory, processing, speech and the ability to perform daily activities.
That number is expected to more than double by 2050 as New Zealand's population ages and experts have said the country is "woefully unprepared".
Janelle Ellis is a registered nurse who started a private in-home care company seven years ago.
Ellis' 30 staff look after 40 clients across Auckland, many of whom have dementia.
Families often pay out of their own pockets for the extra assistance and her services are in demand.
"It's really nice for the family to know that there's somebody there keeping them safe at home," Ellis said.
Visits are typically for two or three hours, several times a week - but some people are supported in their homes for 24 hours a day.
"We always make sure they're eating and drinking properly. Then we do all the medication reminders and also light housekeeping, assistance around the house, maybe some help with the washing, changing the sheets.
"We provide care right through to palliative care," Ellis said.
Her company focuses on providing companionship, rather than rushing to fit lots of clients into one day.
There are benefits to keeping someone with dementia at home for as long as possible if it is safe to do so, especially while their illness is mild or moderate.
"There are health benefits for the client with dementia - there are benefits for the family in terms of an emotional benefit for everybody involved, not having that separation and just that routine and that familiarity is really important and can really have an effect on the progression of dementia.
"Sometimes a visit for as little as two hours a week is enough to keep someone at home.
"We have this sort of archaic way of thinking that you get old, or you get a diagnosis and then you just have to go into care. I think we need to change the way we're looking at it and put more support into community-based care."
Wellington woman Emma-Jane Kung tried to keep her mum Michelle at home for as long as she could.
Michelle was diagnosed with early-onset dementia at just 58.
"We ended up buying this house so mum could live with us. It was pretty much a case of carry-on until we can't cope any longer, which, you know, became quite tricky quite quickly," Kung said.
She accessed the Government-funded in-home care options but it wasn't enough support.
"Some people were great and lovely, others were... You could tell they were in a rush and they've got so many people to see and only so much time," she said.
Juggling her own young family, Kung eventually made the difficult decision to find a permanent care home for her mum to move into but she said the options weren't suitable given her age.
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"A 60-year-old shouldn't be living with 85-year-olds. She wants to be busy and active and involved and doing stuff, but that's not what the current system provides.
"I could quit my job and be a carer which is what a lot of people have to do but I want to keep working and look after my kids.
"But then knowing mum's not really happy, I feel really guilty and I can't find a solution."
Some families can't even find an available permanent care home space for their loved ones.
Alzheimer's New Zealand estimates 30,000 people with dementia who require permanent care are missing out due to a workforce shortage.
Te Whatu Ora Health New Zealand said it knows the aged care sector is facing challenges.
There are currently 5340 dementia beds, or permanent care spots, in New Zealand. That number has increased by 17 percent over the past five years. Te Whatu Ora said it also has Home Support Services available and has allocated $590 million to fund Home Carer Support Services in 2022 and 2023.
It's currently assessing the future demand by conducting a review of aged care funding and service models.
The review will look at the best models of care required to deliver the type of care and beds that will be needed.
In Rotorua, one alternative style of permanent dementia care has been working well for several years.
Thérèse Jeffs started 'The Care Village' which is modelled on a Dutch dementia care village called De Hogeweyk.
The Rotorua village was the first of its kind to be built outside of The Netherlands. The model has six residents living together like flatmates, in 13 mini houses, based on a secure site.
Each home has its own front door and letterbox and care workers are matched to a house they help out in.
"Everything happens in the house; the cooking happens in the house, the laundry happens in the house," Jeffs said.
The focus is on allowing residents to keep participating in normal daily life activities; "To encourage them to maintain some of some of the skills, like if they like peeling the potatoes to peel potatoes. It might take an hour or two to peel the potatoes but it doesn't matter," Jeffs added.
She said residents are more peaceful and would like to see the model operating throughout New Zealand.
"It is the future and I think it should be replicated. All the elderly have done is grown old and some of them have developed dementia.
"They haven't committed a crime and yet we put them in an institution. Whereas this household model is much more like being at home."
Patrick Gower is the host of Paddy Gower Has Issues on Three and ThreeNow.
