On the 13th floor of the Jen Chi station-front building in Taipei, a school bell rings. The room does not feel like a hospital.
Older adults move through simple exercise, cognitive activities, music, conversation, and the small rituals that make a day feel like a day. Some need prompting. Some repeat a question. Some are stronger than their families expected. Nearby, caregivers finally have a little room to breathe.
What stays with me is not any single activity. It is the continuity. No one asks an older adult to become a “patient” for one hour, a “long-term care case” for the next, and a family problem after going home. The person remains the same person.
That sounds obvious. Our systems often behave as if it were not.
This year, World Alzheimer’s Month carries the message, “The Earlier You Know, The More You Can Do.” The message matters. Early diagnosis can open the door to treatment, clinical trials, planning, rehabilitation, and support. The 2026 World Alzheimer Report also arrives at a moment when Alzheimer’s Disease International reports 158 drugs being studied across 192 trials in the global pipeline.
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But there is another question we do not ask loudly enough. You know earlier. Then what?
I have watched families leave a diagnostic conversation carrying a new word (dementia) and suddenly face a scavenger hunt.
- Which specialist should we see next?
- Does this person qualify for long-term care?
- Who checks medications, fall risk, nutrition, swallowing, exercise capacity, home safety, driving, caregiver burden, and legal or financial planning?
- Which service begins now, and which one begins only after the person declines further?
A diagnosis can clarify the disease while making the future feel more confusing. Taiwan is trying to solve this.
Long-Term Care 3.0 began in 2026 with an explicit emphasis on healthy aging, medical-care integration, rehabilitation, family support, community services, and technology. Dementia Policy 3.0, covering 2026 to 2035, brings 12 government ministries into the same national framework. Nearly 400,000 people in Taiwan are estimated to be living with dementia in the community in 2026.
The policy pieces exist. The human pathway is still the harder part.
In planning meetings at Jen Chi, our president, Dr. Shui-Long Lin, often returns to a simple idea: Care has to be substantive. A beautiful building is not care. A new machine is not care. A full calendar of activities is not care. The test is whether an older person can actually live better because the system exists.
That idea has shaped the station-front building, which Jen Chi has positioned as Taiwan’s first “medical-health public welfare building.” I do not think that phrase should be treated as a trophy. It should be treated as a hypothesis to be tested. Can a health building do more than wait for illness? Can it connect diagnosis to movement, nutrition, rehabilitation, learning, and social participation before function is lost? Can it make prevention and dignity as visible as treatment?
This is where a model we call “medical care, exercise, and nutrition” becomes more than a slogan. Medical care identifies disease, risk, medication effects, and safety boundaries. Exercise protects strength, balance, gait, and the ability to stand up, walk to the table, leave the house, and remain part of community life. Nutrition supports muscle, energy, swallowing, weight, and the basic physical reserve that makes movement possible. Social connection gives all of those interventions a reason to matter.
None of these replaces dementia medicine. Together, they help medicine accomplish something medications alone cannot: preserve the person’s remaining capacity to participate in life.
The national policy implication is practical. A dementia diagnosis should trigger a care pathway, not another referral sheet. Within weeks of diagnosis, every family should have a named navigator and a structured review of medical risk, medications, function, mobility, nutrition and swallowing, home safety, caregiver strain, transportation, community participation, and future planning.
The same organization does not have to provide every service. But someone has to own the handoff.
And we should stop judging dementia systems mainly by how many centers open or how many visits are recorded. We should also ask whether people maintain function longer. Whether falls decrease. Whether caregivers report less strain. Whether social participation is preserved. And how long families wait between diagnosis and meaningful support.
These outcomes are harder to photograph than a ribbon-cutting. They matter more.
When the school bell rings again on the 13th floor, the older adults gather their belongings. Some may not remember every activity they completed. But they have moved. They have eaten. They have spoken to other people. Someone expected them to arrive. Someone noticed what they could still do.
That is the part of dementia care that moves me most. Dementia may change memory. It should not erase agency before it has to.
If “The Earlier You Know, The More You Can Do” is going to mean something, then health systems must be ready to answer the question that comes immediately after diagnosis: What do we do tomorrow?
The answer should never be: “Find your own way.” It should be: We know the next step, and you do not have to walk it alone.
Disclosure: The author works with Jen Chi and has participated in planning elder-care initiatives at the station-front building discussed in this essay.
Gerald Kuo, a doctoral student in the Graduate Institute of Business Administration at Fu Jen Catholic University in Taiwan, specializes in health care management, long-term care systems, AI governance in clinical and social care settings, and elder care policy. He is affiliated with the Home Health Care Charity Association and maintains a professional presence on Facebook, where he shares updates on research and community work. Kuo helps operate a day-care center for older adults, working closely with families, nurses, and community physicians. His research and practical efforts focus on reducing administrative strain on clinicians, strengthening continuity and quality of elder care, and developing sustainable service models through data, technology, and cross-disciplinary collaboration. He is particularly interested in how emerging AI tools can support aging clinical workforces, enhance care delivery, and build greater trust between health systems and the public.
