How to eat an elephant…

Improving Speech and Language Therapy & Allied Health Professional post diagnostic support in dementia in Dumfries & Galloway

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Challenges & Choices

Three delayed international flights and subsequent frantic phone calls to the nursery, a hospital admission for exhaustion and the missing of my son’s first steps were enough to encourage me to take a career break from the world of publishing, enjoy my young family, and re-appraise what was important to me. Five years later, although I loved being with my 3 children I decided to retrain as a Speech & Language Therapist. It was a courageous decision and there were days when it seemed impossible that I would ever graduate. On those days my husband would say “Helen, how do you eat an elephant?” The answer of course is “chew by chew!” One step at a time, day by day. Dale Carnegie calls it “living in day-tight compartments” and in our house it’s called eating elephants!

Day by Day

Ten years on and now working in dementia care, I think that this is a valuable maxim for us all. Sometimes it seems that there is so much for us to do, so many people to see, so much desire to do better than we are for those living with dementia and their families. It can be overwhelming.. where to even begin?….

Dumfries & Galloway AHP Post-Diagnostic Support Working Group

There is a national AHP Project in Post Diagnostic Support, which is being led on by Alison McKean, AHP Project Lead (@AliAHPDem). As part of this project, Dumfries & Galloway were selected for a piece of improvement work. We decided to start at the beginning and look at the role of AHPs in post diagnostic support. Representatives from the main AHP groups involved in post diagnostic support were invited to attend a meeting and the day that we first gathered together was an eye opener. It quickly became apparent that we were hazy as to each other’s role in dementia care.

Where did speech and language therapy fit in?

What did Occupational Therapists actually do?

What was an Alzheimer Scotland Dementia Link Worker?

If we ourselves didn’t know how we should all link seamlessly together and how to access each other for support and information, it seemed likely that the people we needed to work with didn’t either. However over the past 6 months we have met together as AHPs and as departments to map referral pathways, to examine our individual service provisions, to look at gaps where things are fuzzy or unclear and how we might fill them.

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View from the Alzheimer Scotland day service

Working with Alzheimer Scotland Link Worker

Ruth Jackson, an Alzheimer Scotland Dementia Link Worker, came to our Speech & Language development day to explain her role and look at ways in which we might work more closely together. For example, as part of her role Ruth introduces people to the “This is Me” resource that collects and provides invaluable information to form truly person centred care. As a speech and language therapy department, we are now aware of this and ask for it to be brought along to any therapy or hospital appointment and use it as a foundation for our therapy. Such a small thing, but such an important one.

Knowing where and how to get information has become key for us all. In the past 3 years we have seen the percentage of people with dementia requiring speech & language therapy in Dumfries and Galloway triple and the balance of our caseloads alter considerably. Taking a trip to the Alzheimer Scotland day centre in Dumfries to find out about sensory day care, doll therapy and twiddle muffs has been all part of our partnership journey. As a speech and language therapy department we are now looking at how we can work with Alzheimer Scotland in providing carer training to families locally.

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Me enjoying the benefits of “doll therapy”

Connecting Digitally

The AHP post diagnostic support working group are also developing an online platform with resources and links to all the AHP groups. Speech & Language Therapy in Dumfries and Galloway also have a Facebook page and use Twitter (@SLT_DG) that we use to link in with Alzheimer Scotland and other specialist dementia or speech therapy groups around the world to keep our patients, followers and friends up to date with what we do or generally interesting articles.

Search: Speech and Language Therapy adult Service:NHSD&G

On reflection

There are still days when it feels like an overwhelming task, but the changes I have seen since qualifying, the hard working and dedicated carers I meet, the NHS Dumfries and Galloway professionals I know who are committed to improving services, the support that Alzheimer Scotland receives from its fun loving and energetic fundraisers, convince me that we are moving in the right direction. How do we improve services for dementia? How do you eat an elephant? Chew by chew. So we keep on chewing together.

pic-4-ConvertImageHelen Moores: Specialist Speech and Language Interventions for Dementia, Education, Assessment & Support Team, NHS D&G


I have been a Community speech and language therapist in Dumfries & Galloway for the past 6 years, specialising in progressive neurological conditions visiting community hospitals, care homes, private residences for swallowing and communication. I also work two and half days a week  as part of a newly formed IDEAS team in Dumfries and Galloway working alongside an occupational therapist, psychologist, social worker and specialist nurse practitioner responsible for writing and delivering training for specialist, acute and community staff when working with people living with dementia.



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