Grenada

There is no clearly documented, nationally standardized dementia test battery mandated in accessible Grenada policy sources. Cognitive assessment is therefore clinically determined, typically conducted as part of evaluation in primary care or following referral to hospital or specialist services. Use of tools such as MMSE or MoCA depends on local service organization, clinician training, and available time, rather than a uniform national protocol, contributing to variability in diagnostic depth and timing.

Structural neuroimaging capacity in Grenada has strengthened in recent years. Public reporting highlights the installation of a 128-slice CT scanner as a major upgrade to national diagnostic services, signaling that CT imaging is now a routine, operational service line rather than an ad hoc or pilot capability. Public fee schedules for CT scans, categorized by service type, indicate that imaging is accessible but often subject to direct charges, even within public facilities. In parallel, private imaging options are clearly present with facilities such as St. Augustine’s Medical Services advertise CT imaging (including 64-slice CT) with radiologist reporting, and external radiology providers describe ongoing CT and sonography services linked to referrals, including coverage for the sister isles. MRI availability is more limited and may require referral outside routine public pathways.

No Grenada national pathway document describes routine Alzheimer genetic testing (such as APOE genotyping or familial dementia panels) as part of standard public care. Where genetic testing is considered, it is most plausibly case-specific, initiated by the specialist and accessed through private services or referral outside Grenada, rather than embedded in routine diagnostic workflows.

Similarly, CSF or blood-based Alzheimer’s biomarkers are not described as standard-of-care in the sources reviewed. Dementia work-up in Grenada appears to rely primarily on clinical assessment and structural imaging, with advanced biomarker testing likely limited, exceptional, or obtained abroad for selected cases rather than routinely available domestically.

Grenada’s dementia and geriatric care landscape is anchored in a mixed public–private long-term care system, as described in national health planning documents. The Government owns and operates the largest public geriatric facility, Richmond Home, and provides subventions to several additional residential care homes, while the Ministry of Social Development runs a Home Care Program serving more than 150 older persons. Despite this infrastructure, official assessments highlight significant gaps in staff training, particularly in privately run homes, uneven quality of care, and inequitable geographic access to geriatric services. Dementia-specific specialization within these facilities is limited, meaning care is often custodial rather than cognitively informed.

Mental and behavioural health services, which frequently intersect with dementia-related needs, are delivered primarily through Mt. Gay Hospital, with policy commitments to integrate mental health into primary health care over time. However, national planning documents acknowledge persistent barriers, including stigma and discrimination, overcrowding, and limited human-resource capacity, all of which constrain effective dementia-related mental health support.

In this context, civil society plays a critical gap-filling role. The Grenada Alzheimer’s Association provides caregiver-focused awareness, education, and support, while the GDI positions itself as a newer, community-based organization offering holistic support to people living with dementia and their families. Together, these organizations function as essential connectors between families and a fragmented formal care system.

Treatment and ongoing care costs represent a substantial burden for households. With out-of-pocket spending exceeding 50% of total health expenditure, families commonly incur direct costs for private consultations, diagnostic imaging, long-term residential care, home-based support, and non-pharmacological services, even when public options exist. These costs accumulate over time in a progressive condition such as dementia and influence whether care is initiated early, maintained consistently, or scaled back, reinforcing socioeconomic inequities despite the presence of publicly supported geriatric services.

Grenada’s health planning framework implicitly places significant responsibility on families and care homes, particularly in the face of staffing shortages and training gaps. Caregivers therefore shoulder much of the practical, emotional, and financial burden of dementia care. This is precisely where NGOs function as system “bridges”: the Grenada Alzheimer’s Association and the GDI provide caregiver education, awareness, peer support, and practical signposting, helping families navigate services and cope with caregiving demands in a system without a standardized dementia pathway

Publicly accessible sources do not indicate the existence of a dedicated, formally adopted national dementia strategy in Grenada. Instead, dementia-related action is addressed indirectly and in a fragmented manner, embedded within broader policy areas such as health system strengthening, services for older persons, and mental health integration. While national planning documents recognize population ageing and the growing need for long-term care, they stop short of elevating dementia to a standalone policy priority with clearly defined care pathways, protected funding, and accountability mechanisms. Consequently, dementia is managed within general service structures, rather than through a coordinated, rights-based framework tailored to the specific needs of people living with dementia and their caregivers.

Despite the absence of a dementia-specific strategy, policy momentum is emerging. Media reporting in 2025 indicates that the Government, with technical support from PAHO, is advancing work toward a National Policy on Ageing, with healthy ageing positioned as a central organizing principle. This process offers a clear policy entry point for embedding dementia priorities, such as risk reduction, earlier identification, caregiver support, and long-term care planning, even without a standalone dementia plan.

In June 2025, the UN Women began providing technical support to the Government of Grenada to revise and strengthen legislation on child and elder care, following Cabinet approval. The initiative , part of the Canadian Build Back Equal Project, aims to modernize maternity and parental leave, introduce child benefits for low-income families, promote gender-equal caring responsibilities, and protect domestic and care workers’ rights. Grenada has already raised the national minimum wage in caregiving sectors and collected data on unpaid care work to inform policy. Grenada has also collected data on unpaid care work to inform policy and will undertake a national cost analysis of care to estimate what is required to achieve universal access for older persons and people with disabilities. Together, these measures can reduce caregiver burden, improve job protection and income security for family caregivers, and strengthen the care economy, creating a more supportive legal and social framework for families caring for people living with Alzheimer’s and other dementias

Innovation in Grenada’s dementia response is pragmatic and service-oriented rather than biomedical. Two developments are particularly notable. First, investment in diagnostic capacity, especially the expansion of CT imaging services, strengthens differential diagnosis pathways and reduces reliance on external referral for basic structural imaging.

Second, community-based dementia support models, led by civil society, represent an adaptive response to system constraints: organizations such as the Grenada Alzheimer’s Association and the GDI emphasize caregiver empowerment, raising awareness and early help seeking as a way to mitigate crisis-driven care and delayed presentation. These approaches function as low-cost, scalable innovations in a small health system.

In 2021, Grenada undertook significant Smart Hospital retrofitting at Richmond Home for the Elderly and the Central Medical Stores, implemented by PAHO with UKaid funding, to strengthen the resilience of critical health infrastructure. For people living with Alzheimer’s and other dementias, the upgrades at Richmond Home are particularly relevant: improvements included hurricane-resistant structures, enhanced accessibility and age-appropriate washroom facilities, safer sanitation systems, and energy-efficient cooling and lighting, all designed to protect residents’ safety, dignity, and continuity of care during disasters and climate shocks. Parallel upgrades to the Central Medical Stores, such as HVAC and fire-safety enhancements, help safeguard the reliable storage of medicines and supplies, reducing service disruptions that disproportionately affect older persons with chronic conditions. Together, these investments strengthen Grenada’s capacity to maintain dementia-relevant care and medication access during crises, underscoring the importance of resilient infrastructure in ageing and Alzheimer’s care.