Both the Scottish Dementia Working Group (SDWG) and the National Dementia Carers’ Action Network (NDCAN) of Alzheimer Scotland have been involved in a Collaborative Improvement Programme in collaboration with Healthcare Improvement Scotland, Care Inspectorate and NHS Scotland since it began.
The programme aims to reduce stress and distress for people living with dementia within inpatient and residential settings by ensuring:
effective processes are in place for the assessment and early recognition of stress and distress
• person-centred approaches are being used to prevent and manage stress and distress
• meaningful engagement with the person and carers in all aspects of care, and
• staff are confident and skilled in the prevention and management of stress and distress.
This programme tested a framework which sets out what is expected from high quality, person-centred care for people living with dementia to reduce stress and distress. The framework can be used by teams in hospitals and care homes to self-assess their service against a set of quality criteria. The criteria are based on what has been learned and is important in the prevention and management of stress and distress based on person-centred approaches. The learning from this work will inform the codesign of a national improvement offer to support other areas in Scotland.
In 2025, 59 teams joined the improvement programme – 54 teams completed the year (27 hospital teams and 27 care home teams). Teams were supported to self-evaluate their current practice, identify improvement priorities, develop change ideas and test those change ideas – 57% of teams reported testing change ideas.
Teams tested a range of change ideas including person-centred care plans, meaningful activity, early identification of stress and distress, continuous intervention, carer involvement and staff knowledge and confidence. Most of the impact reported is anecdotal and included:
• reduction of antipsychotic medication
• reduction in falls
• reduction in incidence of stress and distress, and
• improved staff understanding.
At the learning event held at the COSLA (Convention of Scottish Local Authorities) building in Edinburgh, teams which had taken part in the programme came together to share learning, problem solving and exchange ideas, celebrate the progress and build on collaboration between hospital and care home teams. SDWG member Rynagh Flynn shared a bit about Active Voice and spoke to the teams about why this work so important to people and their families. Rynagh, fellow SDWG member Kenny and NDCAN colleague Marion, have supported and collaborated on the work attending many planning and delivery events, ensuring the voices of lived experience are central in the learning programme going forward, with another two in-person learning events planned for the autumn.
Pictured: Adeline and Maureen from the Focus on Dementia Team alongside Rynagh and Wendy from Alzheimer Scotland’s Active Voice
