CASCADE – Community Areas of Sustainable Care And Dementia Excellence in Europe – was part of the Interreg VA 2Seas programme and ran from 2017 to 2023.

It was part-funded by the European Regional Development Fund and involved partners from the UK, The Netherlands, Belgium and France (see below for partner details).

Model of delivery

Click here to access the full CASCADE model of delivery.

Evaluation reports and summary

To access findings from the Evaluation Study of the CASCADE Model at Implementation Sites in Belgium click here and at Implementation Sites in the UK click here.

The CASCADE training programme can be accessed at:

Total project value: 12,573,153.15 euros

ERDF value: 7,543,891.89 euros
Funding rate: 60%

This exciting project developed a financially sustainable approach to elderly dementia care that can be replicated across Europe. Uniquely, it exploited existing unused public housing stock to create facilities providing both short-term respite care as well as longer term residence. The facilities also fully engaged with the local community, offering opportunities for shared use and everyday interactions. The premises were also a hub for telemedicine and enabled a cascade of shared learning and cross-border excellence in dementia care for the future.

Background to the project

Ageing is one of the major societal challenges identified both by the cooperation programme & Europe 2020. According to Francesca Colombo, OECD “Health systems across the OECD are still too hospital focused & struggle to innovate approaches to care for an ageing population. There is certainly still a gap between the needs of the elderly & the way care services are organised & produced. Making the needs of older people central to the development of services & products will help. There is a need to encourage innovation as a way to improve productivity in caring”. CASCADE was an original approach that sought to meet 3 of the OECD’s long term care priorities ensuring fiscal & financial sustainability, enhancing standards of quality of long term care services & care coordination between health & long term care.

At present older people spend unnecessary time blocking hospital beds as there are no suitable facilities for them pre or post a medical operation that provides more care than what they would receive in their home context (this may be residential care or their own home) but less care than a hospital bed. Hospital beds are very expensive for the state to pay for (approx €4K/bed/week).

The challenge is to provide care for elderly patients with unmet needs to maximise their independence and respond to their different needs at different points in time. It must integrate them more closely with their communities in a manner that can be applied in different geographic & social settings with the emphasis on people living with dementia staying in their own homes for as long as possible in a safe and supported way.

CASCADE brought together an anecdotally highly successful but unevaluated small scale care model for elderly patients (guesthouses) with dementia experts from across the 2Seas region to build evaluated facilities. Via co-creation they ensured that patients do not become isolated from their local community. By using disused publicly owned housing stock as the basis of a new freely available model of service delivery, transferrable to the private sector CASCADE had wide applicability & was financially sustainable. Furthermore CASCADE also addressed the issue of economic regeneration in coastal areas as the new centres are based in coastal areas, driving the creation of new jobs in the caring sector.

The project delivered:

  • A new holistic model of care for people living with dementia and the elderly in local communities encompassing respite, rehabilitation & residential care. This model is financially sustainable, relevant to both public and private settings and freely available.

  • A cross border centre of elderly/dementia care excellence through telemedicine to promote virtual consultation/learning/research/innovation 50 new beds across two countries for the elderly and people living with dementia

  • 50 new beds across two countries for the elderly and people living with dementia

  • New multilingual learning package providing training for all people having contact with people living with dementia.

  • Internationally peer reviewed evidence base, showing the cost saving of this new way of working leading to project roll out across 2Seas area & further.

CASCADE videos:

The Health and Europe Centre was the Lead Partner in this project and will be working with:

  • Canterbury Christ Church University (UK)

  • Emmaus Elderly Care (BE)

  • Flemish Expertise Centre on Dementia (BE)

  • Residential Care Holy Heart (BE)

  • University of Lille (FR)

  • HZ University (NL)

  • ZorgSaam (NL)

  • Medway Community Healthcare CIC (UK)

  • East Kent Hospitals University NHS Foundation Trust (UK)

There are also a number of observer partners: La Vie Active; Flemish Minister on Wellbeing, Public Health and Family Care; Zorgnet Icuro; Flemish Agency Care
and Health; Tourism Flanders.

Scroll to Top