5 thing you need to know about The AHP Approach in Dementia Care

Connecting people, connecting support presents an evidence-informed case to support an approach to practice for allied health professionals* when working with people living with dementia – what we call the AHP approach.


The AHP approach reflects the fact that dementia affects people in very individual ways, and that people require tailored responses to best meet their needs, aspirations and wishes.

It provides a foundational underpinning from which AHPs will be able to build, using their own skills, experience and understanding of the person to provide a service truly tailored to individual needs.

The aim is to build on the strengths of the AHP professions collectively not by doing more, but by supporting them to work in integrated and innovative new ways.

5 things you need to know about the AHP Approach 

  1. The AHP approach is applicable for all people with a diagnosis of dementia in all care setting
  2. It is underpinned by principles of human rights using the PANEL approach as a framework
  3. The fundamental understanding driving the approach is that people living with dementia CAN benefit from AHP-led interventions.
  4. The AHP approach combines a biopsychosocial approach of care with an integrated and co-ordinated approach to providing AHP interventions.
  5. The five elements in the AHP approach are described separately, but must be considered collectively within overall universal, targeted and specialist AHP interventions

We would be interested to hear from you and welcome any comments about the AHP approach

  • what do you like about the AHP approach?
  • what would make the AHP approach even better?

*The allied health professionals include: Arts therapists, Diagnostic radiographer, Dietitian, Occupational therapists, Orthoptist, Orthotist, Paramedic, Physiotherapy, Podiatrist, Prosthetist, Speech and language therapist and Therapeutic radiographer

Stay connected

Twitter @AHPDementia #AHPDementia #AHPConnectingPeople

Blog http://www.alzscot.org/talking_dementia

You can find the full report here and the evidence informing the report here


Raising Awareness & Importance to Eating Well When Living with Dementia


12-18 March 2018

I am delighted to have this opportunity to raise awareness of the importance of nutrition and dementia during Nutrition and Hydration week.  I am Lynne Stevenson, Dietitian and External Affairs Advisor, Nutricia Advanced Medical Nutrition, Member of Alzheimer Scotland’s AHP Dementia Forum and a daughter who has cared for my dad who lived with dementia.  I feel passionate that about the role that good nutrition plays in overall health and well-being as well as the integral role it plays in illness and disease

Many people living with dementia may experience a change in their relationship with food, eating and drinking.  As dementia progresses, the behavioural, emotional and physical changes that can occur can make eating and drinking more difficult.  Depending on the individual, these changes can result in dehydration, weight loss or weight gain.   In some cases a person living with dementia may lose weight unintentionally due to a variety of reasons including poor appetite, a change in food preference, co-ordination problems and chewing and swallowing problems

Some tips to encourage a person to eat

  • Be flexible around times of meals
  • Offer small snacks and meals more often and throughout the day
  • Taste preferences may change so offer food enjoyed in the past as well as new foods
  • Sweet or spicy food may be favoured so try adding honey to vegetables or sweet sauces to meat dishes
  • Finger foods can be eaten more easily if co-ordination is difficult
  • Chewing and swallowing problems may become more apparent so it is important to speak to a GP who will be able to make a referral to a speech and language therapist who can carry out an assessment and provide help with managing any difficulties.

It is important that those at risk of malnutrition are identified early and managed appropriately.  There are various tools and resources now available to help sign post individuals and Health Care Professionals to identify the risk of malnutrition, and what to do to manage it.

Further information on eating well when living with dementia

Carers UK and Carers Scotland in partnership with Nutricia have developed a range of resources on the importance of good nutrition within long term conditions, including dementia.  For more hints and tips on how people living with dementia can enjoy meal times and get the best from their diet, please refer to “Eating well with Dementia” guide  www.carersuk.org/help-and-advice/health/nutrition/dementia-and-nutrition

Learn more through the e-learning module at www.carersuk.org/for-professionals/carersuk-products/e-learning-courses/e-learning-role-of-nutrition

Allied health professional’s . Who they are and how they CAN help leaflet

Eating Well with Dementia

Contributor :
Lynne Stevenson,
Dietitian and External Affairs Advisor,
Nutricia Advanced Medical Nutrition,


Achieving Positives Outcomes for People with Dementia in Acute Care

Focus on Dementia in partnership with colleagues in Aberdeen Royal Infirmary have produced a publication which explores the critical success factors which lead to improved outcomes for people with dementia, their carer’s and staff in acute care, which we would like to share with you. Focus on Dementia is a national improvement portfolio based within the ihub of Healthcare Improvement Scotland. We work in partnership with national organisations, health and social care practitioners, people with dementia and carers to reduce variation and improve quality of care.


We know that people living with dementia are more likely to be admitted to hospital than people without dementia, and are estimated to occupy 25% of acute inpatient beds. This means that approximately 6% people living with dementia are inpatients at any one time.

When admitted to acute care they tend to have a longer length of stay, have more adverse outcomes such as falls, pressure ulcers and infections, and are more likely to be discharged to a care home.

Scotland first developed a national dementia strategy in 2010, with commitments around improving the outcomes and experience of people with dementia and their carer’s. Commitment 10 of Scotland’s second national dementia strategy focused on improving acute care for people with dementia. To support this commitment, 10 Dementia Care Actions were agreed.

As part of this work Focus on Dementia aimed to identify the critical success factors associated with positive outcomes for people with dementia, their carers and staff in acute care by exploring the success factors in a department which had demonstrated good practice in relation to the 10 Dementia Care Actions, the Department of Medicine for the Elderly, Aberdeen Royal Infirmary.

We used an appreciative inquiry approach to capture information on the success factors within this department from a range of sources, including a multidisciplinary workshop, conversations with staff, stakeholder questionnaires, data collection and thematic analysis using the 10 Dementia Care Actions as a framework.

The project identified 15 different critical success factors under the 10 Dementia Care Actions. The main themes we found were:

Quality improvement is every day and everyone’s business

The whole multidisciplinary team were involved in agreeing and working on improvement priorities using improvement methodology. This was supported by the local leadership within NHS Grampian. They meet every week as part of their “QI Fridays”.


Focus on dementia-specific knowledge and skills/leadership

The department make a real effort to ensure the staff had the appropriate level of dementia specific knowledge and skills. They also utilise the support from the local subject matter experts such as the local Alzheimer Nurse Consultant and the Older Adult Mental Health Liaison Team.


Focus on delivering good person-centred care

The department use person-centred approaches such as “Getting to Know Me” and “What Matters to Me” and shared documentation to really get to know their patients and their needs and to inform care planning.

Focus on making best use of the care environment

The department improved the physical environment using audit and dementia-friendly design including improved lighting, reducing noise levels, improved décor in dayrooms, murals to add interest and signage to support way finding. Therapeutic activities are recognised as an essential part of day to day life and not an add on.


You can find our much about this work including; what the critical success factors identified were, why they are critical and how the department achieved them in a publication we produced to capture the learning. This will inform improvement work in acute care supported by Focus on Dementia and the wider acute care programmes in Healthcare Improvement Scotland. We feel the learning from this work will be of interest to other inpatient sites across Scotland, and staff will be able to use the learning to identify opportunities to improve the care and experience for people and people with dementia their own areas. The link for the publication can be found here.




Lynn Flannigan


Lynn is a HCPC registered Allied Health Professional (Physiotherapist) working as an Improvement Advisor as part of the Focus on Dementia Team in the iHub of Healthcare Improvement Scotland

Twitter: @ihubscot  @FocusOnDementia

Email: Lynn.Flannigan@nhs.net      Hcis.focusondementia@nhs.net

Web:  http://ihub.scot/focus-on-dementia/


Lyn Irvine-Brinklow


Alzheimer Scotland Dementia Nurse Consultant
Acute Sector

NHS Grampian

Email: lynirvine-brinklow@nhs.net

Bringing People bring people together through language


One of the common myths cropping up when people discuss dementia is that it’s an inevitable part of the ageing process. And whilst it’s true that the likelihood of developing dementia increases with age – and that the majority of people living with dementia are over the age of 75 – there is nothing necessarily inevitable about it. In fact, there are many proven ways to minimise risk and reduce the chances of a dementia diagnosis.


Photograph with permission of Lingo Flamingo

One such way is language learning.

Research shows that those who are able to speak a second language tend to develop dementia up to five years later than monologuists. This is down to the fact that language learning keeps the brain active by employing the ‘desirable difficulties’ of novelty, challenge, and effort. That’s to say, the constant juggling between distinct sounds, new words, and unfamiliar concepts acts as an efficient brain work-out, building up higher levels of what is known as ‘cognitive reserve’, leading to a healthy and active mind.

What’s more, the stimulating effects of language are not confined to those who learnt their second language in early life, nor those who have mastered their language perfectly. Rather, directed language learning has been shown to positively effect mental performance and ability after just one week. Therefore, regardless of your age, ability, or diagnosis, the power of language learning can have a positive impact on your life.

Energised by this research, we at Lingo Flamingo have developed a colourful array of language classes for older individuals.


Photograph with permission of Lingo Flamingo

One variation of our classes is a language learning experience for those living with dementia. These leisurely classes take into account the medical, physical, and mental health of learners in order to employ the senses, keep the brain active, build confidence, and foster connections between participants. We’ve worked with individuals at all stages of dementia diagnosis, and 90% of our students say they loved the classes and felt an increased sense of confidence and self-worth.

Further to this, we have developed a bespoke basket of classes for those over 65 who embrace life-long learning and who are seeking new, enriching experiences in retirement. These research-powered classes offer a unique way for individuals to get back into learning, build confidence, exercise the mind and, most importantly, to have fun whilst doing it. As we say, our classes are good for the brain and good for the banter.

If this is something you, or someone you know, would be interested in then contact us here to book you free, no obligation taster class.


Robbie Norval

Director of Lingo Flamingo

Lingo Flamingo provides language workshops for elderly people in order to fight dementia and promote well being. Classes for people in care homes or groups in Spanish, French, German and Italian.


This blog was originally posted here and we are delighted to share it with you on Lets Talk about Dementia

Connecting People, Connecting Support Improvement in Practice – My 6 Top Tips

Dementia is everybody’s business and I strongly believe that improvement in practice is also  everybody’s business.  With the recent publication of Connecting People, Connecting Support I thought it would be a good time to reflect on my experience of improvement in practice so far.  Having always had a strong commitment to improvement but being aware of how much I always have to learn, I keep in mind the following quote:

“Continuous Improvement is better than delayed perfection”

Mark Twain

In 2016 I was fortunate enough to gain a place on Cohort 9 of the Scottish Quality and Safety Fellowship, which was an amazing experience (further information available on the Quality Improvement zone).  This provided me with the opportunity to deepen my knowledge and understanding, as well as receive invaluable mentorship and support.  It also provided me with the ability to develop my use and accuracy (most of the time) of improvement quotes!

Here are my 6 Top Tips supported by some of my favourite quotes.

1. Prepare to Fail


I was trying to run in the Lake District – lots of failing in preparation for the Lakeland 100 race!

“Ever tried.  Ever failed.  No matter.  Try again.  Fail again.  Fail better.” 

Samuel Beckett

I look back at some of the pieces of improvement work I have been involved in and could write a whole blog about the failures!  The wrong timing, the wrong problem, the wrong data (I could go on) but without the failures, there wouldn’t have been the learning and successes either.  Don’t ever be afraid to try.

2. Seek to Understand

“The biggest communication problem is we do not listen to understand.  We listen to reply.”


How many times have you met with someone and thought to yourself – “it’s fine, I know the answer to this, I know what this person needs”.  For the AHP Dementia work and for my Fellowship project, we spent a lot of time ‘seeking to understand’ from the real experts – people living with dementia and their families.  We have used numerous methods to gather person experience feedback and have uncovered so much valuable information, at times completely different from what was expected.  Pause and make sure you really listen.

3. Power of relationships

“Coming together is the beginning.  Keeping together is progress.  Working together……is success.”

Henry Ford

We have been privileged to work alongside such motivated and talented teams whose commitment to improvement in practice is inspiring, both for the AHP Dementia work and within NHS Dumfries & Galloway.  Any successes are due to great relationships and teamwork so thank you!  Chocolate also helps.


4. Start small, then make it smaller, then make it smaller again!

“Dream Big.  Start Small.  Act Now.”

Robin Sharma

While dreaming big is usually never an issue, I am grateful to the numerous people who have suggested that my Aim may not be achievable within my timescale (or the next decade come to that!).  Ask for help in breaking your idea down in to chunks and Act Now.

5. The importance of measurement

“without data you are just another person with an opinion”


This has got to be one of my favourite quotes and I think it speaks for itself.  Be clear on what you are measuring and why and then your data will also speak for itself.

6. Patience and reflection


I have foregone a final quote in favour of my dogs who I like to include in any presentations or blogs!  Here is a rare photo of Scapa (left) and Ruby sitting still to illustrate the importance of patience and reflection as those are two key elements of any improvement journey.  I’ll finish by thanking the many people who have supported and contributed to my improvement journey so far………



Alison McKean,

Alzheimer Scotland AHP Post Diagnostic Lead, and Mental Health Occupational Therapist, NHS Dumfries & Galloway

Caring to Communicate: Enabling care partners to support people with dementia

Connecting People, Connecting Support highlights the valuable role of AHPs in supporting people living with dementia to have positive and fulfilling lives.  Communication, and the ability to make meaningful connections, helps to maintain psychological wellbeing and reduce stress and distress.  In the remote communities of the Western Isles, we respect and value the assets of Third Sector organisations in keeping people living with dementia connected to the people and places they value the most.

Like most Board areas, there are only a few Adult Speech and Language Therapy (SLT), so exploring new ways of partnership working is essential to accommodate the changing needs of the local population.  We offer a rolling programme of training sessions to Third Sector carers (paid and unpaid) and volunteers throughout the year.

Simple communication supports such as visual menus, communication passports, music, and sensory stimulation are explored.  The aim is to empower carers and volunteers to support positive communication by offering simple, practical communication advice.  We also aim to highlight access to our service, so that carers can contact us directly for advice and support.


AHPs often worry about an ‘avalanche’ of new clients when they experiment with new ways of working.   Although contacts within our service have definitely increased, these are often consultative in nature, with carers getting in touch to see what THEY can do to enhance interaction.  Carers have commented on how helpful it is to be able to speak directly to SLT rather than having to navigate complex referral systems just to get some simple advice.

“Loved the focus on preserving humanity and dignity of the person to the last”

“Learned little easy tools to help people communicate”

“Don’t feel so lost”

Karen Mackenzie

Speech and Language Therapist/Scottish Voice CEN Secretary

Western Isles Hospital

We need to continue to challenge the expectations of what it means to live with dementia

When I joined the Care Inspectorate in January 2013 one of the first conversations I had with colleagues was about building on the work of Remember I’m Still Me, a thematic piece of research on dementia in care homes published in 2009 by the Mental Welfare Commission and the then Care Commission.

Last year, the Care Inspectorate published the report My life, my care home (The experiences of people living with dementia in care homes in Scotland). It presents the findings of our focused inspection work examining the extent to which the Standards of Care for Dementia are having an impact on the lives of people living with dementia in care homes. This report builds on some of the work of Remember I’m Still Me and sets the scene for a range of improvements in the coming years.



Person-centred care

Scotland has a unique policy landscape with a range of dementia standards, educational frameworks and three national dementia strategies. These strategies have mapped the experiences of the person living with dementia from diagnosis through end of life. At every stage of this policy development an important aspect was listening to the lived experience of people affected by dementia, those living with the condition and those supporting them. This policy context sits well within the new national Health and Social Care Standards and positions the person experiencing care and support at the heart of everything we do.

The big question is: have things changed since Remember I’m Still Me was published? Overall, I would say yes because in many ways we have seen tangible changes. For example, we found that many care homes are now collecting rich personal details about the person they are supporting, including life story books full of great family photos. However, we did not always find this information is being used to make a positive difference in the lives of those who are being supported.

We also found that the majority of care homes now have secure gardens. However, the next question is whether people can people access these gardens independently. We found that this was not always the case. In fact, over a third of care home gardens cannot be accessed independently and require staff to be available if a person wants to go out into the garden.

So, we can see that the key ingredients of quality care and support are often present. However, something appears to be lost in how these components come together. It was interesting to see that where staff understand and live the vision of the service then outcomes are better for those living in that care home. So, maybe this is how we move from task-driven care to a truly person-centred approach?

Within the Care Inspectorate, we have embedded the Promoting Excellence Framework for all health and social services staff working with people with dementia, their families and carers. However, this framework still needs to be fully understood and implemented in care homes. For example, staff development is not simply keeping a record of attendance at training. It should be a live and dynamic learning and development opportunity, which leads to improvements in the culture and delivery of care and support.

I was extremely encouraged to see that the majority of services no longer look to medication as the frontline response to stress and distress in a person living with dementia. This is a positive move and a key indicator that staff are looking more into the complexity of what it means to live with dementia. However, when we looked at whether care homes promote continence or manage incontinence we know work remains to be done to challenge expectations and what is considered ‘good enough’.

What next?

I believe that we need to continue to challenge the expectations of what it means to live with dementia. We need to think about rights and citizenship being maintained, regardless of the degree of cognitive impairment that a person may be experiencing. We need to continue to support the sector to test out improvements, which can make a difference not only to the lives of people living in a care home but also to the staff working there.

We need to take a holistic view, so that one domain of a person’s life is not seen as more important than any other. The fundamentals of care are absolutely essential but so are providing meaning and opportunities for growth. Potential and hope need to be the bases of our expectations for care and support.

At the Care Inspectorate we are committed to ensuring that quality of life for people is not limited due to lack of expectations of what it means to be an older person living with dementia in a care home.

If you would like to find more information and resources on improving care for people living with dementia visit The Hub website’s Spotlight on Dementia.

The report My life, my care home is available on the Care Inspectorate website and the report Remember, I’m still me is available on The Hub website.

Written By 


Heather Edwards, AHP Consultant, Improvement Support Team (Portfolio: Dementia, Frailty and Palliative and End of Life Care) Care Inspectorate


Blog first published on the 18th December 2017 at