Picture terrified dementia patients with behavioural problems locked away and under medication in a psychiatric hospital. Then think about these same people being managed with kindness and humanity in home-like surroundings. The difference is due to Dr John Tooth and his work with the Adards Nursing Home. Since 1991, both have become internationally renowned institutions, demonstrating that even the most difficult problems in dementia can be handled in comfortable surroundings provided that there are special design features and well chosen, skilled, and caring staff . When Japan banned the use of physical restraints in dementia units six years ago, they turned to John for advice. Now, as well as his unpaid clinical work, including being on call 24/7, John lectures in Japan, Canada, the USA, and the UK; teaches Japanese professionals who come here for training in his methods; and has written the definitive textbook on this kind of care.