Objectives:The authors describe factors that facilitate positive changes in dementia care as perceived by long-term care employees.Background:Creating positive changes in dementia care is a complex undertaking involving multiple variables. The perspectives of long-term care employees may provide important insight and direction for a successful change process.Methods:A convenience sample of 181 long-term care employees utilized a q-sort methodology to provide data for this descriptive study. Results were analyzed using rankings and Spearman's rho correlation coefficient.Results:The facility factors most often cited as important for making positive changes in dementia care involved teamwork, administrative support, staff attitude, and knowledge. There was little congruence between facility factors identified as ideal for providing dementia care and those identified as actually evident at the subjects place of employment. Personal characteristics that were identified as most important for facilitating positive changes in dementia care include genuinely liking people with dementia, being flexible, kindness, calmness, and having a positive attitude. The correlations between ideal and real personal factors were higher than for the facility factors.Conclusions:This study supports the idea that the fundamental tenets of good leadership-communication, involvement, and empowerment-are foundational for real change in dementia care to be attained and sustained.