Dementia

Hello! Emma and Aoife here. We are Occupational Therapy Students from Queen Margaret University on a 10-week placement with Alzheimer Scotland. During this placement, we have been working with Active Voice Members from the National Dementia Carers Action Network (NDCAN). Emma and I had the pleasure of hosting a conversation with Ian, a NDCAN member, to enable us to write a blog scribing Ian’s story. I hope you enjoy this blog helping us all to know who Ian is.

In conversation with Ian

Ian is a member of the National Dementia Carers Action Network and he was a devoted husband who cared for his wife Nancy throughout her journey with dementia. It was important to Ian to share his story, he describes it as, his story matters as it shows what compassionate home care can look like when families and services truly work together. In sharing his experience, Ian offers a glimpse into the strength, compassion and partnership that made caring at home not just possible, but meaningful. Ian describes a positive experience of caring at home due to the influx of support from their local community, early and coordinated care, and partnership working.

Ian cared for his wife, Nancy, throughout 14 years of her dementia journey, supporting her closely since her diagnosis in 2008 up until her end of life. As her mobility and independence declined, especially after she became bedbound, Ian became her constant companion, handling everything from eating and drinking to daily company, supported by a dedicated team of home carers. Home was where Nancy felt most comfortable, surrounded by familiar routines, cherished memories, and the people who loved her. For Ian, keeping  Nancy at home wasn’t just a preference, it was an extension of their lifelong partnership, a way of preserving her dignity, independence, and the way they’d always done things as a pair.

“We always were a pair that did things together”

“It wasn’t a task. It was just the way we lived.”

Actively involved in his wife’s care, Ian shared cherished memories of their annual trip to the Isle of Skye, a very meaningful place. However, he noticed a change in Nancy’s care needs through these trips as she progressed in her journey with dementia. Ian explained how he would not see the progression as clearly at home due to their will structured routine at home.  Ian told us that as Nancy’s journey through Dementia progressed, typical walking distances were shorter, stairs became difficult to manage, and he describes transfers from the car became a challenge, as it became difficult to follow verbal instructions. However, Ian found creative ways to support Nancy, such as using a coin that was in the footwell of the car to direct her attention to transferring, as direct instructions were unclear for Nancy.

Ian and Nancy were a well-known couple in their community and wouldn’t need to look far for a helping hand. Neighbours and friends would often drop by to have a conversation, allowing Ian to be present to enjoy these visits where Nancy was also included. Home carers also ensured to include Ian in his wife’s care, alongside building both a personal and a professional connection. Ian and Nancy connected with Occupational Therapy, Speech and Language Therapy, Community Psychiatric Nurse (CPN) and their General Practitioner. He highlights how the early access and signposting from these services were essential.

“People were very helpful. If you look for the good in people, it’s there.”

For Ian, partnership working was what made caring for Nancy at home truly possible: a network of family, home carers, nurses, therapists and a CPN who all communicated, anticipated needs and worked as a unified team. Ian spoke of the importance of his  family support saying “looking back now, my family were a huge support to me, not only in the earlier years but especially when Nancy was housebound and during Covid. My daughter and her husband took their holiday in Skye at the same time but stayed in different accommodation to give us some independence but support when needed.  My son supported us before moving to Australia in 2014 and offered help and advice through his role as a music therapist. I think it could have been impossible without their support”. The continuity of familiar staff visiting four times a day meant Ian felt supported rather than alone, and he trusted their skill as well as their kindness. Ian described being listened to, included in every decision, and treated not just as a bystander but as a lifelong partner in Nancy’s care, someone whose knowledge of her was valued. When challenges arose, from equipment needs to changes in swallowing or mobility, solutions were found collaboratively and quickly, reducing both the emotional load and demands on Ian. This shared responsibility created a safety net that held both of them, allowing Ian to focus on simply being with Nancy, allowing Ian to be a part of the team, he never assumed or wanted this caring team to solely carry out care for Nancy without his involvement.

“That became virtually our family. These were the people who came in four times a day, looked after her, looked after me to a certain extent as well.”

Ian summarised in 4 points what he describes as “What Good Care Can Look Like” and these are outlined below:

• Compassionate, clear and constant communication from healthcare professionals.
• Maintaining person-centred care whilst considering internal support.
• Ensuring services available are discussed and offered in a timely manner.
• Consistency throughout services and coordination where appropriate.

“I’ve had a positive experience”… “why is that not happening now?”

Ian and Nancy’s story showcases how compassionate, coordinated and person‑centred care can transform the experience of living and caring with dementia at home. Through strong partnership working, early support and a community that truly showed up for them, Ian was able to remain an active, valued part of Nancy’s care. Their journey highlights what good care can look like and questions why others are not on this similar journey.

“I don’t think she would have wanted to be in a care home, but I didn’t want her to be.”

If you want to learn more about the National Dementia Carers Action Network or join, please visit this link here

Question for consideration:

Have you ever thought about what your care preferences would be if required for the future?

Contributors:  Aoife Gordon, Emma Galloway, Queen Margaret University, Occupational Therapy Students

You can find the Alzheimer Scotland 24 hour Freephone Dementia Helpline, for information, signposting and emotional support to people with dementia, their families, friends and professionals here

Allied Health Professionals have created a suite of information resources for people with dementia, their families and carers that you can find here

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An interview with an Occupational Therapist

Hello, my name is Sarah Whyte and I’m an Occupational Therapist working in the dementia assessment wards at the Royal Edinburgh Hospital. In this blog, I’ll discuss the Cognitive Stimulation Therapy (CST) group programme we offer, and its value for the patients on the wards.

1. What is Cognitive Stimulation Therapy and more specifically, what are the groups?

For the past 10 years, the Occupational Therapy team in the dementia assessment wards in the Royal Edinburgh Hospital (REH) have been successfully running CST groups – “a programme of memory provoking, problem-solving and conversational fluency activities” – as an intervention to help address the behavioural & psychological symptoms of dementia. This was recommended in SIGN Guideline 86 – Management of patients with Dementia. Although this guideline was superseded in 2023, CST is currently recognised as an essential rehabilitation intervention to optimise the mental and cognitive functions of people living with dementia, featuring in the 2023 “World Health Organisation (WHO) Package of Interventions for Rehabilitation (PIR) for Dementia”.  (https://iris.who.int/server/api/core/bitstreams/6c0d3f5d-6d20-4424-af4b-4f6ff04b84e3/content.

The WHO PIR for Dementia describes CST as “aiming to improve cognition and psychosocial functioning in people with difficulties in cognitive functions (e.g. memory, thinking, attention and perception deficits). During CST sessions, participants … engage in exercises that are mentally challenging, to improve their ability to think and interact effectively with their environment and with other people”. We describe it to our members as “something fun, to get us thinking, while spending time together as a team”. We explain that for both our physical and mental wellbeing, it’s as important to exercise our brains as much as our other muscles.

We offer an evidence-based “programme of memory provoking, problem-solving and conversational fluency activities” by following the group structure outlined in the “Making a Difference” manual by Spector et al (2015) which was produced following their research (Spector et al, 2003). They created a group intervention of varied enjoyable activities for men & women with mild to moderate dementia, aimed at “enhancing cognitive function and quality of life”.

In conjunction with the ward multi-disciplinary teams, the Occupational Therapists identify 4-6 patients to attend the block of 14 sessions, which are run for an hour, twice a week over 7 weeks.  We select and prioritise potential members based on their clinical need, and to ensure a therapeutic experience for all, their ability to meet specific criteria:

• having a diagnosis of dementia or cognitive impairment

• communicating and interacting positively within a group setting

• consenting to attending each session

CST is run as a ‘closed’ group to foster a sense of orientation, familiarity, ownership and belonging – this means the same 4-6 people are invited to attend every session in the 14 session block. This is reinforced by the members collaborating to choose a group name and theme song, which is played to mark the start and end of each session. We hold the sessions in the ward activity room which is a lovely, quiet, accessible space, and each session is led by 2 Occupational Therapy staff members. We try as much as possible to keep the staff consistent. Likewise, each session follows the same structure:

• Welcome & introductions
• Orientation board
• Theme song & warm-up (e.g. balloon tennis)
• News article
• Themed activity
• Goodbyes & theme song
• Group feedback

These strategies hopefully help build a therapeutic environment for the members.

In general, the sessions involve using reminiscence as an aid to the here-and-now, providing triggers to help memory, and the different props used for each themed session can offer a multi-sensory experience. Each session has a different theme to keep interest and to exercise all areas of the brain.

Also, as per the guidance, it’s important to ensure we include the following principles in every session

1. Why are CST groups of value for people with dementia in a hospital setting?

As mentioned previously, CST is a recognised form of rehabilitation for dementia, which is important in itself: within the “World Health Organisation (WHO) Package of Interventions for Rehabilitation (PIR) for Dementia” document, the benefit of offering rehabilitation to the 52 million people worldwide living with dementia is highlighted: “With…supportive treatment and rehabilitation, the lives of people with dementia and their carers can be significantly improved. Interventions for rehabilitation in dementia…all help not only to maintain independence and well-being, but also to be engaged in a meaningful life as long as possible”.

Being in hospital impacts our ability to keep to our usual routines or have the chance to engage in the daily activities we used to do before admission, which can mean our brains aren’t getting the work-out that they normally would. Without some form of cognitive rehabilitation opportunities whilst in hospital, there is a real risk of further cognitive and functional decline which could impact a person’s ability to return home or transfer successfully to care-home life.

 The rehabilitative value of regular CST sessions lies within the offer of a new routine for patients, and the chance to ‘use their brains’ within a varied range of topics and activities. Actually, CST manages to meet 2 of the recognised ways to keep your brain healthy (https://www.alzheimersresearchuk.org/brain-health/brain-health-basics/. ) Just as keeping connected to the people around us important for our brain health, it is also thought that challenging your brain helps to build your ‘cognitive reserve’, which is the brain’s ability to cope and keep working properly, even in the face of damage from diseases like Alzheimer’s.

We also find the CST groups play a huge role in the Occupational Therapy process – they can be a really good way to assess people’s abilities, as well as being a form of therapeutic intervention. The variety within the sessions can also highlight a person’s activity and environmental preferences, which can be taken into consideration when planning therapeutic ward activities for them or community activities post-discharge.

Because of all the specific benefits that CST can offer, people are prioritised for attendance based on their clinical need with each session aiming to target those needs:

1. People who are going home, to maintain their cognitive function and provide experience of daily structure
2. People who would benefit from more cognitive stimulation than could be provided effectively in general ward activity, to promote recovery and improved mental health
3. People who require assessment of their daily living skills, to enable occupationally focused discharge planning.

We evaluate each CST group afterwards to check we’re getting it right – that the group aims have been met and that we are offering a fun, useful, and stimulating time for the group members. We complete the observation sheet from the manual and ask the patients to complete a simple visual feedback form along with capturing any verbal or written feedback they want to offer (Spector et al, 2015). This also helps us plan and adjust future session content to be more effective for them.

3. What value does Occupational Therapy facilitating bring to the group sessions?

With our core professional skills in group work, observation and activity analysis (Turner and Alsop, 2015), Occupational Therapists are well-placed to combine each session’s particular topic with the 18 core principles of CST to creatively plan then deliver stimulating, meaningful and purposeful sessions accessible to patients with wide-ranging cognitive abilities. We can use our knowledge of adapting and grading activity to make it accessible and meaningful for each patient in accordance with their abilities. We will consider the therapeutic value of the group and the contribution it may have made towards maintained cognition and function, through observed enjoyment and active engagement in the session.  

1. Can CST be continued after discharge, or done at home?

Yes! There are CST groups being run in the community for people who it is felt could benefit from more sessions. There is also a manual for ‘individual CST’ available for purchase which fully outlines sessions that carers can do with the person they care for (ward OTs can advise on these options more specifically).

I hope this has given you a little insight into a valuable intervention we do with the people we work with.  Thanks for reading!

Contributor. Sarah WhyteOccupational Therapist, Older Person’s Mental Health In-patient Dementia team, Royal Edinburgh Hospital

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Following on from our blog series by AHPs in NHS Lothian about how AHPs can provide rehabilitation for people with dementia the focus this time is on occupational therapy.

In our final blog of this series we are showcasing the contribution of Occupational Therapy  and finish off with some thoughts from people with dementia about what rehabilitation means for them. The blog starts with Lynsey and she discusses Occupational Therapy Home Based Memory Rehabilitation (OT HBMR) and what difference this made to someone living with dementia and his wife.The second example is from Nikki, who works as an Occupational Therapy Assistant Practitioner and she reflects on working with someone to help them learn to use new technology.

My name is Lynsey Robertson, and I am an Occupational Therapist working as part of a multi-disciplinary team with the Memory Assessment and Treatment Service in Edinburgh.

What does rehabilitation and dementia mean to you?

For me rehabilitation and dementia is about acknowledging that a dementia diagnosis is not the end, but rather a new chapter in a person’s life. It is about finding small changes to a person’s lifestyle that can make big differences in keeping them independent and taking part in the activities that are important to them. We are never too old to learn new things, and exercising your brain can help to keep it healthy in the same way that exercising your body keeps it healthy!

Can you tell us about a time you provided rehabilitation for someone with dementia?

The service that I work in uses a wonderful program called “Occupational Therapy Home Based Memory Rehabilitation”. OTHBMR SDWG YouTube – YouTube This involves working with an individual over a period of around six weeks and finding person centred, tailor made strategies which they are then supported to implement.

I worked through this program with a husband and wife and found some positive outcomes. One of which was, the wife of the person living with dementia was struggling to access meaningful activity as when she left the house her husband would worry about where she was, often telephoning her on multiple occasions when she was out. This was upsetting for both the person with dementia and his wife. We introduced a whiteboard with the recommendation that his wife could use this to note where she was, and when she was due back. This was placed next to an orientation clock to allow the husband to clearly see the details on the whiteboard, and the time alongside it. This small intervention had a big impact, allowing the wife to return to activities that she enjoyed and a significant reduction in stress for the husband who was able to relax and enjoy reading rather than worrying while his wife was out of the house.

Contributor – Lynsey Robertson, Specialist Occupational Therapist, NHS Lothian

I’m Nikki Ferrier and I work as an Occupational Therapy Assistant Practitioner on older people’s mental health assessment wards in Edinburgh.

What does rehabilitation and dementia mean to you?

With the changes in policy, more people receiving a diagnosis of dementia and research into what helps people with dementia live well there is much more knowledge of the benefits of rehabilitation. This can include specific strategies to support people, including how to continue with everyday activities that are important, connecting with their communities and using existing or new technology. This is where a rehabilitation approach comes in.

Can you tell us about a time you provided rehabilitation for someone with dementia?

I’ve worked with people who have a diagnosis of dementia or cognitive impairment in many different ways. One of the areas I’m often asked to look at with people is how technology can support people to live safely and as independently as possible at home.  This is also helpful for family carers as it can give reassurance and peace of mind.  Families can often be a positive support to help people get used to using new technology and overcome any issues that might arise.

I worked with a gentleman recently who had never used a mobile phone and needed one for moving out of hospital and into his new accommodation. We looked together at what phones were available, what he needed it for and I accompanied him to purchase one, ensuring it was going to meet his needs and he would be able to use it. We set it up together and programmed useful numbers into it. I continued to meet with him regularly before he was discharged from hospital to practice using it and provided him with a prompt sheet to help him recall the key steps to making and receiving calls. He went from someone who was a little fearful and unsure of technology like this to someone who was able to use the phone confidently.

My advice to anyone who is thinking about trying to use technology would be to give it a go and try it, if it doesn’t work out there are always other options. You may also find that there are local groups or services in your community that can support people who are new to using technology or you can access national services such as ADAM through Alzheimer Scotland.

Contributor: Nikki Ferrier, Occupational Therapy Assistant Practitioner, NHS Lothian

Finally, to sign off this series of blogs we would like to share the thoughts of people with lived experience to illustrate directly the value of AHP input. This is outlined in the “Connecting People, Connecting Support: looking back, looking ahead report” in 2024 by the Scottish Dementia Working Group and the National Demetia Carers Action Network.

“A number of us have had direct access to AHPs. Their support, guidance and rehabilitation interventions have been invaluable to us, and we want to ensure that other people living with dementia, their families and carers also have access to their expert clinical experience.”

If you would like to see more about how people with dementia have integrated rehabilitation into their own lives have a look here: AHP Extract01 SDWG Rehab video

We hope you have enjoyed reading all the blogs about the difference that can be made by Allied Health Professions. If you would like to read more or access resources developed by us please have a look at the Alzheimer Scotland website – Allied Health Professionals – Alzheimer Scotland

Thank you to all the contributors who so generously shared their stories.

Morna Russell, AHP Lead for Connecting People Connecting Support, project on rehabilitation, NHS Lothian.

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I’m currently a fourth-year Speech and Language Therapy student at the University of Strathclyde and this experience formed my Impact Project. Going into it, I expected to learn more about dementia (which I definitely did), but I didn’t quite anticipate how engaging, reflective and enjoyable the process would be.

My role involved creating a leaflet and a series of posters specifically aimed at giving practical tips on how to communicate with someone living with dementia. It really pushed me to think about how we communicate information in a way that is accessible, clear and helpful for people living with dementia and their families.

 Something else that really made this experience so positive was the support I had along the way. I was so lucky to be guided by skilled occupational therapists and speech and language therapists throughout the project. Anytime I felt a bit stuck or unsure, they were always there to offer feedback, answer my questions, and point me in the right direction.

One of the biggest things I’ve taken from this experience is just how much thought and care is needed when supporting someone with dementia. It’s not just about understanding the condition itself but understanding the person, their communication needs and the people around them. Working on this project has helped me to appreciate that in a much deeper way.

 I also enjoyed how creative the whole process was. As speech and language therapy students, we spend so much time focusing on theory, evidence and clinical skills but this project gave me the chance to learn in a completely different way. Designing a leaflet and posters meant I had to translate what I’d learned into something practical and meaningful. Which felt very rewarding.

I can already see how this experience will benefit my future practice. Dementia care is such an important area and having this early exposure has given me a really strong foundation. It’s helped me understand how small changes in communication and our environment can have a big impact on someone’s quality of life. You can find the communication leaflet here and the leaflet will be shared soon at www.alzscot.org/ahpresources.

Overall, this project has been such a valuable part of my final year. It’s deepened my knowledge, challenged me creatively. I feel grateful to have had the opportunity to work alongside Alzheimer Scotland and I know this is something I’ll carry forward into my future career as an speech and language therapists.

Alzheimer Scotland is a fantastic organisation, and I would highly recommend working with them

Contributor. Aiobh Hendron, 4^th year speech and language therapy student, Strathclyde University

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Transformational Leadership in Action

An AHP Dementia Webinar

As an allied health professional (AHP) dementia community we have developed a National AHP Dementia Webinar series where we share practice, connect people, to support. In 2025, we moved all the webinars to be delivered on the Microsoft teams’ platform.

In our AHP Dementia webinar in November 2025, people joined us to hear the impact of three Connecting People Connecting Support (CPCS) AHP leadership roles and the impact the AHP leadership roles had to supporting local communities, the AHP workforce and integrated the voices of lived experience of dementia in Scotland. Our guest presenters & former AHP Clinical Leads for Connecting People Connecting Support:  

• Angela Pointon, NHS Grampian
• Gillian Trotter,  NHS Lanarkshire
• Angela Watson, NHS Greater Glasgow & Clyde

You can WATCH AGAIN; the webinar link is here

You can view all our AHP Dementia webinars here and over the next few months we will be sharing the full report on the impact of the AHP CPCS leadership roles. You will find the report at www.alzscot.org/ahpresources.

If you joined us live at the webinar session in November, or you are listening again to the recording, we would encourage you to take a few minutes and share with us your thoughts. Simply Click the link to comment and let us know – https://forms.office.com/e/LZdT9GjvD8

• What did you like?
• Even better if..?
• What are you planning or have already done next with what you heard? 

We would love to hear from you and feeding back provides a positive contribution to transforming the support available in Scotland available to people living with dementia.

COMING SOON.  Our AHP Dementia webinars this year will be held on:

• 22^nd April from 3.30pm – 4.30pm “Connecting You to Support: Allied Health Professions. Who are they and how can they help you?” – AHP Dementia Webinar on 22^nd April 2026,  3:30 -4:30pm.  Join this interactive session to learn about the self-management resources which AHPs in Scotland have been developing to support people with dementia. Find out how you can access these resources to support people you know. Guest Presenters :  Elaine Hunter, National AHP Dementia Consultant , Alzheimer Scotland, Claire Craig, Physiotherapist,NHS Ayrshire and Arran and Claire Clark, Speech and language therapist, NHS Grampian

Follow the link to register: https://events.teams.microsoft.com/event/325ca22f-5aa2-4d82-bbc5-cb1b097d947d@10efe0bd-a030-4bca-809c-b5e6745e499a

• 3^rd June from 3.30pm – 4.30pm where Elaine Hunter, Fiona Maclean and Laura Bolton will be talking about dementia rehabilitation and what this means in  policy, practice and for people with lived experience.

• 30^th September from 3.30pm – 4.30pm. We would welcome any idea on what you would like us to share in our AHP Dementia webinar series?

• 9^th December from 3.30pm – 4.30pm where Elaine Hunter, Claire Craig and Helen Fisher will be sharing their work to co-design person led planning, sharing the evidence, practice and the co-desinged toolkit.

Email us at AHPDementia@alzscot.org for more information or to let us know what content you would be interested to learn more about.

Stay connected.

We post daily@AHPDementia

We blog weeklywww.alzscot.org/talking_dementia

We support our AHP students to share their work at AHPDementia Instagram 

We share self-management resources at www.alzscot.org/ahpresources

We have an email for youto send questions  AHPDementia@alzscot.org

We developed an interactive website with 32 resources for you www.cpcs.online

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Throughout health boards in Scotland, it is no secret that diagnostic times are lengthy and vary depending on where you live.  Some can take up to 3 or 4 appointments and times vary from 8 weeks to over 12 months.  This can be very stressful for all involved.

We know that evidence shows a better outcome for people who receive a diagnosis of Dementia earlier. We know that people live well for longer when supported. Yet we still have a huge waiting list to tackle.

How can we improve this with a shortage of doctors?  How would you feel about receiving a diagnosis from a masters qualified NURSE? 

Learning in Practice

In an are in Lothian in 2019.  A post was created for a trainee advanced nurse practitioner to work within the memory clinic.  The nurse completed training through 3 masters modules, including advanced patient history taking (the important part) being able to assess you holistically and to rule out all other causes that can impact on cognitive problems.  What has changed for you and your loved ones?  Functionally, emotionally and how is that impacting on your life?

Work based learning module – To learn to read bloods, ECG’s and scans and assess the person fully and finally non-medical prescribing.  Being able to prescribe the medication you require if suitable at point of diagnosis.   The nurse was heavily supervised by psychiatrists, neurologists and geriatricians.  She quickly became competent in the role, with years of dementia practice before in wards and in the community as a community mental health nurse.  

From a plan to training to Action

On qualifying from university, the nurse then began nurse led diagnostic clinics.  Fully autonomously.  Receiving the referral from the GP and a full assessment from the community nurses she would hold clinics twice weekly and complete home visits the remaining two days.  Seeing over 20 people a week for assessment and diagnosis.  There were referrals completed to psychology or allied health professionals if required but this was fully nurse led from the assessment to formulating the diagnosis, prescribing and arranging post diagnostic support. 

The team with this post in place were able to bring the diagnosis waiting times down from 12 months to 4.2 months.  Allowing people more timely diagnosis and quicker treatment plans and support.  The nurse also completed a capacity and consent course and was able to order and read CT, MRI and DAT scans of the brain. 

What’s next?

The model has been adopted and currently in place in other areas of Scotland.  But has this been adopted and utilised quick enough?  Despite the evidence and data collected, this is still a rare model of practice for dementia diagnosis. 

We continue to promote the pathway, and the hope is that each health board will consider adopting a nurse led diagnostic clinic into their area too.

Final thoughts?

This model has been in place now for almost 6 years and the diagnostic times in this area continue to be stable.  The feedback received from individuals who have received their diagnosis this way has been heartfelt and positive.  This is a cost effective and patient centred way of thinking outside the box to improve on diagnostic waiting times.

The cost implication is relatively low with upskilling the nurse and it also allows for clinical career progression for nurses, whilst directly impaction on waiting times for people waiting on a diagnosis of dementia, when we know this can be a timely, confusing and difficult time for the individual and their loved ones. 

At the heart of all of this is one simple fact:
When we have timely access to diagnosis and support, the outcome for the person and their loved ones improve and that is truly what matters.

So…. Would you be happy to accept a nurse led diagnostic appointment?

Contributor. Mel Rowlands, Nurse consultant in Dementia, NHS Lothian

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I am a second-year MSc Art Psychotherapy student at Queen Margaret University coming to the end of my placement with Alzheimer Scotland. I began in September 2025 and have been here two days a week within a post-diagnostic day service. Over these seven months, I have gained valuable experience both as a practitioner and personally, facilitating two small art therapy groups and working one-to-one with individuals. As I near the end of my placement, I’ve been reflecting on my journey and the key lessons that have deepened my understanding of how art psychotherapy can support people living with dementia. This blog post shares five meaningful insights I’ve taken away.

1. . The power of structure and predictability

Consistency creates a deep sense of safety in a world that can feel uncertain for people living with dementia. Knowing that sessions happen at the same time and in the same room each week helps reduce anxiety and builds trust. If we think about Bowlby’s attachment theory, the therapy space can help create a reliable and secure base for exploration and expression. Often, I start a session with a simple grounding practice: maybe a short breathing exercise to connect us with our bodies and bring us into the here and now, perhaps noticing how we feel in the chair. It might also include a gentle check-in as a way of meeting in the space. It’s a way of creating a slow transition into therapy. In a shared day service space that changes throughout the day, these small consistencies signal when therapy begins and ends, and what is held within the therapeutic frame. They help the space feel containing and dependable.

2. Responding to what emerges in the moment

A client-led approach means staying open and curious to whatever arises for individuals. One week someone might engage deeply with clay; the next, they prefer dry materials or chatting. These small surprises often reveal preferences, moods, or unspoken needs in that moment. Being adaptive keeps the therapeutic space flexible, respectful, and responsive. For example, materials that can be engaged with in a multitude of ways like leaves, pinecones and other nature items have been wonderful for cultivating the present moment: they offer something tangible and tactile that invites people to connect with the here and now without any pressure to create a finished piece. We can simply observe textures, feel the shapes, and be together. At the same time, leaves make excellent print makers, perfect for gentle leaf rubbing or collage when someone feels ready to explore further. I am continually surprised by the unique and deeply personal ways each person connects with these materials, and I am always learning from clients.

3. Expression without words

Art offers a gentle bridge when words become harder to find or share. Art therapy is a way of communicating without the need for words. On placement with Alzheimer Scotland, I have seen how connection with materials in a safe therapeutic space within a therapeutic relationship opens access to emotions and memories, supporting connection. Art is a language: we speak through shapes, colours, marks, and textures. This non-verbal way of expressing supports deep connection and a continuing sense of self. Above all, I have seen how creativity reveals what remains very much present in each person.

“[The creative arts] can help to link us back both to the shore of identity and to the core of our being. They keep us in contact with our hearts. They can help to keep us afloat and connected (to self and others) while we change from who we once were to who we are now.”

Hayes, J. and Povey, S. (2011. p.16). The creative arts in dementia care : practical person-centred approaches and ideas.

4. Integration with team/holistic care

Art therapy isn’t isolated at Alzheimer Scotland, it complements the wider support available. Working alongside daycare practitioners, volunteers and other professionals, we all share the same aim: supporting the wellbeing of people living with dementia in ways that feel meaningful to them. I’ve seen first hand how art therapy groups create a relational space where people can simply meet and ‘be with’ one another, sharing presence and gentle interactions. Early in my placement, learning about the different roles of others and giving a short introduction to art therapy helped build collaboration and mutual understanding. It showed how art psychotherapy can be integrated sensitively into the service, honouring the human, person-led moments that everyone brings. I’ve truly enjoyed hearing about the work of my colleagues and witnessing how a team’s diverse skills come together to create something richer and more supportive.

5. The freedom of choice

In this day service, art therapy can offer agency and opportunities for choice at every step. Laying out a range of materials allows people to engage exactly as feels right that day, whether that’s collage, creating swirling patterns with oil pastels, or exploring paint in countless ways: sponges, pipettes, dipping objects, or feeling it between fingers. This flexibility respects where each person is that day. People have often shared how they can “just zone out” and lose themselves in the making, especially when they choose materials that resonate personally. Each individual can use the tools in their own way, making their unique marks without pressure or expectation.

What I’m bringing with me

This placement has reinforced my belief in art as a powerful tool for wellbeing and connection to the self and others. Alzheimer Scotland’s community and person-centred approach valuing choice, collaboration, and everyday support, has shown me how art psychotherapy can truly enhance post-diagnostic life in meaningful ways. It has been wonderful to see the joy and connection when people have created something that has meant something to them.

Above all, I’m carrying with me the quiet power of presence and the adaptive flexibility to meet each moment as it arises. These experiences have touched me deeply and will shape how I create spaces as a therapist going forward.

Thank you for reading!

Discussion Questions:

• How has creative expression supported wellbeing for someone you know living with dementia?
• What questions do you have about art psychotherapy in dementia care?

Contributor. Millie Davies, Second-Year MSc Art Psychotherapy Student, Queen Margaret University on placement with Alzheimer Scotland.

BAAT – https://baat.org/art-therapy/

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Robotics have a key role to play in the enhancement of health and wellbeing.

I was at a meeting at Heriot-Watt Robotarium on Tuesday 12th August 2025. It was a most pleasant and informative visit and was enjoyed by all NDCAN and SDWG members

Following our visit, I decided to complete and post a blog which had been sitting on my computer for a considerable time. It is focused on the future of robots as caring assistants from the perspective of caregivers. Although it is not related to the detailed, ongoing research at Napier and Heriot-Watt Universities, I have taken the liberty of including a reference to your work in one of the ‘Footnotes’. I did so as I think that it is important for readers to be aware that such relevant research is taking place in Scotland.

Introduction

I first met a humanoid-robot in the Alan Turing Institute of the University of Strathclyde in Glasgow. The occasion was in the 1980s. Along with a colleague, I was involved in a research project which focused on pupil-software interaction. It was fun to watch the robot’s antics in the laboratory but its value as a learning machine was very limited. How times have changed in 50 years of investigation and experimentation!

An overall aim of research in robotics is the enhancement of the standards of the daily habits and wellbeing of all relevant parties. Future developments in the sustenance of persons with incapacities and their carers will include an emphasis on key aspects of medication, technology, and lifestyles. There is much that robots can achieve in making headway in these areas. Nonetheless, it is essential that ethical matters such as those concerning privacy, dignity and independence of persons being supported are fully respected and the know-how of their guardians is increased (Mecalupu and others, 2025). Additionally, there inevitably will be issues regarding the costs of  construction and ongoing maintenance of robots and, on occasions, problems in fitting them into their operating environments, particularly if they are intended to be available on a 24/7 basis.

“A robot may not injure a human being or, through inaction, allow a human being to come to harm.” (Isaac Asimov (1920-1992),  author of “I, Robot”, a collection of science fiction short stories.)

In an age of mistrust and mere speculation, robust research will assist professionals and carers in establishing the most effective methods of intervention while taking due account of the needs and wishes of those whom they are supporting. The further development of robots’ potential entails multidisciplinary cooperation among practitioners and researchers with testing and exploration ‘outside of the box’ to ensure a truly reciprocal and first-rate human-machine partnership. At the same time, protective considerations need to be taken into account in case of mismanagement or lack of skillsets.

There is substantial evidence that efficient use of robotics will augment the competences and deployment of a caring, nation-wide workforce. Key questions are: “How should professionals and researchers identify and develop pertinent capabilities for robots in order for them to act as expert carers?” and “What are the most suitable tasks and responsibilities which can be passed over to these computerised assistants?”  A useful starting point is to analyse the opinions, talents, and dexterity of those dedicated persons already at work in this area. Once aims are agreed, the next stage would be to devise programs to ‘incorporate’ these qualities and proficiencies within robotic carers.

The interface of robotics, carers, and persons in need of care

Robots come in many shapes and sizes and can be designed to undertake single, specific chores – lifting, toileting, playing games – or alternatively to carry out multi-functional cognitive, emotional, and practical assignments. The applications of robots offer assistance and support for persons with a diverse range of disabilities – for example, dementia (Wu and others, 2025). Assigned undertakings may include acting as an inbuilt feature of a person’s clothing to reinforce the power of their muscles or to help in carrying out physical exercises which have been prescribed by physiotherapists. When acting as coaches, they have an affirmative, educational role in informing carers about relevant publications, outlining best-fit objectives for those in their care, and suggesting bespoke training packages towards the attainment of desirable goals. In a real sense, the more a robot can accomplish a wide variety of benevolent duties, the more it moves forward towards emulating a competent human caregiver.

The advancement of robots with ‘caring expertise’ will centre on their ability to: boost working relationships between carers and those requiring aid; promote confidence, self-belief, enthusiasm, and curiosity; identify individuals’ strenghts and weaknesses; foster imminent progress away from current levels of disadvantages; encourage essential everyday social and interpersonal skills at an appropriate pace while steering clear of targets which might be overwhelming; and avoid the fallacy of ‘one size fits all’ when assessing needs and recommending proposals concerning progress. They also have the capability to create and/or participate in services, amenities, and leisure pursuits – such as safety procedures; contacts with families and friends; reminiscences about joyful previous occasions; news reports; recordings of favourite songs and music, etc. – to suit individual interests and tastes. Taken together, these positive qualities will endow robots with a ‘personality’ which is friendly, caring, non-judgmental, and a genuine facilitator of physical wellbeing and good mental health. (For instance, see Footnote No. 1 regarding robots assisting with ‘time travel’.) Supplementary hi-tec and refined improvements in the domain of ‘digital empowerment’ (or what might be referred to as CRISMATICS, namely proficiencies in the use of Computers, Robots, and Artificial Intelligence) are constantly being achieved. In particular, technological upgrades encompassing online, hybrid and blended assistance are introducing a broad array of choices comprising robotic features relating to mannerisms, gender, dress, accent, social aptitudes, selected pastimes, and hobbies. Similarly, many related practical skills and tips – making apt changes to one’s home; managing medication, cerebral rehabilitation, and preplanned healing processes; engaging with companies and providers – could be incorporated to expand a robot’s breadth of usages. (The Scottish Dementia Working Group, 2024, contains feasible themes for inclusion.) As the extent of personal requisites are diverse and varied, the availability of differing types and categories of androids will be generated to meet individualised requirements. There can be little doubt that, in their forthcoming roles as carers, robots will become progressively helpful in ameliorating the lives of persons experiencing disabilities, aiding their caregivers, and working constructively alongside qualified specialists, such as occupational therapists and other allied health professionals.

Impending challenges facing researchers and developers.

In researching on how best to engage robots, attention will need to be paid to both qualitative and quantitative features. For example, regarding persons living with dementia and their carers, qualitative aspects could embrace a wide range of robots’ competences and users’ preferences as well as their facility to enrich communal contexts and lived experiences (Shi and others, 2025). Researchers may wish to explore how to adopt more nuanced approaches to established habits as regards: offering to help in difficult circumstances; enhancing interpersonal relationships and mental health; proposing guidance on recreational and leisure activities; using good communication skills; finding how best to exploit robots’ infinite patience; making appropriate use of humour; counteracting distress; and giving more time and opportunities for carers to engage in other essential pursuits. Quantitative enquiries could involve collecting and analysing data as measures relating to emotional responses, personal satisfaction, and efficiency in reinforcing key skills. Accurately-gauged, measurable analyses of micro-moments and movements have the capacity to identify pathways towards advantageous targets. Thorough, solution-focussed research across a complex interplay of situations may reveal which factors are the most impactful and transformative. By aggregating with artificial intelligence (AI), conclusions can be drawn and suggestions outlined regarding environmental improvements. Two expedient advances could be a greater focus on: (1) statistically evaluating the quality and suitability of assistive robots’ contributions to recipients’ security and welfare; and (2) their accuracy vis-à-vis feedback when making recommendations pertaining to measures of contentment and self-worth. Clearly, detailed studies to further promote motor and cognitive factors are required to ascertain successful procedures and long-term outcomes. (Seino, 2024.)

“There are endless number of things to discover about robots. A  lot of it is just too fantastic for people to believe.” (Daniel H. Wilson, author of “How to Survive a Robot Uprising”)

Concluding comments

Research has indicated that robotic care interventions have the potency to enrich the quality of the  lives of vulnerable people (Nam and Park, 2025). Nevertheless, given the complexity of challenges which carers can encounter, it is meaningful for ongoing investigations to discover innovative ways for their apposite involvement when being employed. In combination with topics mentioned already, areas of interest could include robots’ roles to: make adept use of kindness and good manners in enhancing relationships between carers and those being supported; overcome social marginalisation and loneliness by establishing novel forms of friendship and comfort; show empathy when a person is confused, troubled, or distressed; improve carers’ knowledge, understanding, and indispensable skills; and suggest appropriate strategies, such as compassion-focused therapy, to address specific needs. Briefly stated, robots have the potential to provide ‘wrap-around scaffolding’  to enhance and maintain lifestyles by concentrating on what really matters.

At the beginning of this paper two key questions were raised about the current use of robots as carers. The challenges for future developments can be reviewed by spotlighting two other related and important enquiries: “How can the ‘robotic revolution’ be implemented more effectively in the promotion of the principles and attributes underlying first-class care?” and “How best can both carers and those in need of assistance benefit from scientific advancements in practical, accessible, and flexible ways?” During periods of rapid progress it will be crucial that best practices, and the added value of robots’ pragmatic contributions, are made well known to caregivers.

A mischievous question: Will the day come when a robot self-evaluates its efforts by resorting to its own version of the ‘serenity prayer’ reflecting as to what is beyond its control, asking for the courage to continue to do good work, and requesting wisdom to know the difference? (See Footnote No. 2.)

Footnotes

1. Carers can feel hassled on occasions and, particularly when they are under pressure, they may lose track of their timing of routines and responsibilities. It is relatively easy for them to program a robot to ‘time travel’ – a term sometimes used for providing questions and nudges about duties either to caregivers or to those whom they are assisting. For example, for a person in need of care the robot might say: “It will soon be time for you to take your medication. Shall I fetch it for you? Be sure to take one capsule, along  with a glass of water.’’ Or to a caregiver: ‘‘You have had a very busy morning. If it is not raining, perhaps you may want to go outside and relax for 10 minutes or so? Or would you rather listen to some music?”

2. The serenity prayer has been attributed to Reinhold Neibuhr (1892 -1971). It emphasises the importance of reflection, courage, and wisdom – all key features of high-quality caregiving!

3. The website of Edinburgh Napier University contains helpful insights regarding the integration of robotics into occupational therapy and dementia care, including a video highlighting key aspects of this topic.

Contributor. Frank O’Hagan

Originally posted on the 31^st August 2025 and you can see it here The Future of Robots as Caring Assistants – Improving Care and Education. Reposting at Lets Talk about dementia with permission of Frank. The home page for my website is here

References

1. Seino, K. (2024) An Exploratory Literature Review of Robots and Their Interaction as Assistive Technology for Persons with Disabilities: Focus on Promoting Activity and Participation. In Baratgin, J., Jacquet, B., and Yama, H. (eds.) Human Artificial Rationalities. HAR 2023. Lecture Notes in Computer Science, Volume 14522. Springer. Cham.

2. The Scottish Dementia Working Group (2024)  Our “Top Tips” for living well with dementia. Published by Alzheimer Scotland.

3. Mecalupu, V., Miller, E., Martin, L., and Caldwell, G. (2025) Human-robot interactions and experiences of staff and services robots in aged care. Nature, Scientific Reports, 15, Article Number 24945.

4. Shi, W., Zhou, W., Wang, R., Shen, H., Xu, N., and Wang, J. (2025) Exploring the perceptions and experiences of caregivers with the application of socially assistive robots in dementia care: A systematic review of qualitative studies. International Journal of Nursing Studies, July 2025, Volume 167: 105084.

5. Nam, S. and Park, E. (2025) Effectiveness of Robot Care Intervention and Maintenance for People with Dementia: A Systematic Review and Meta-Analysis. Innovation in Aging, Oxford University Press, Volume 9, Issue 3.

6. Wu, D., Pu, L., Jo, J., and Moyle, W. (2025) Technologies and Applications of Robots in Dementia Care: A Systemic Review. Journal of Intelligent and Robotic Systems, Volume 111, Article number 33.

Linked blogs include:

1. Technology at work on behalf of persons being cared for and their caregivers https://improvingcareand.education/2022/10/25/technology-at-work-in-social-care/

2. Good Practices: Enhancing Brain Health – biological research, technologies, lifestyles https://improvingcareand.education/enhancing-brain-health-biological-research-technologies-lifestyles/

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In 2024/25, I had the opportunity to work for 12 months within the Memory Assessment and Treatment Service (MATS), supporting people following a diagnosis of dementia. As a specialist mental health physiotherapist, this role allowed me to work alongside a multidisciplinary team to provide early, person-centred post-diagnostic support.

My core aim was simple but powerful: to help people living with dementia build and maintain a meaningful life through physical activity.  This support wasn’t just about treatment — it was about self-management, wellbeing and preserving independence at a time when people are often feeling overwhelmed and uncertain about the future.

Pattern we can change

I have worked as a physiotherapist in mental health for over 25 years. During that time, I have seen how dementia can negatively affect mobility, often leading to what is known as the “shrinking world phenomenon” — where a person’s world gradually becomes smaller until they may become isolated or housebound. But this trajectory need not be inevitable.

People living with dementia can gain enormous benefit from remaining active, engaged and visible in their communities. Being out in public, visiting stimulating environments and maintaining social connections all contribute to cognitive stimulation, physical health, and emotional well-being. This is where physiotherapy plays a vital role — encouraging movement, supporting confidence and enabling participation in meaningful everyday activities.

Why early physiotherapy makes a difference

Seeing people at the post-diagnostic stage is key. Early physiotherapy input allows us to embed

falls prevention strategies, mobility support and self-management skills at a time when individuals and their carers are often more motivated, receptive and open to guidance.

A dementia diagnosis can be frightening and emotionally challenging. As a mental health physiotherapist, I bring both clinical expertise and a deep understanding of the psychological impact of the condition. This allows me to introduce physical activity as a management tool in a professional, empathic and achievable way, tailoring interventions to suit the individual’s needs, physical and cognitive abilities and priorities.

What does post-diagnostic physiotherapy look like?

During the 12 month trial, interventions varied depending on the individual, but commonly included:

• Falls risk assessment and prevention advice
• Equipment and home adaptations to improve safety
• Assessment of outdoor mobility and improving confidence
• Walking aid provision
• Individually tailored home exercise programmes
• Referral to community-based exercise groups, such as Movement for Memories in Edinburgh
• Signposting to other relevant services

The focus was always on what matters to the person – helping them continue to do the things they enjoy for as long as possible.

Outcome of the trial

Feedback from individuals and families consistently highlighted the positive impact of physiotherapy input — particularly the sense of reassurance, confidence and hope it provided.

Some of the comments received included:

“I really do think this has helped my dad and has put my mind at rest that we are doing all we can to help him.”

“The physio noticed areas of concern we hadn’t seen and suggested helpful equipment and exercises. This has given my dad confidence and me reassurance.”

“This visit was the most useful thing we have had since her diagnosis.”

“I felt understood and supported at my own pace. I’m now doing my exercises and starting to go out more.”

These reflections reinforce the value of early, specialist physiotherapy in shaping a more positive

post-diagnostic journey.

A missing piece in dementia services

Physiotherapy input within MATS is still relatively uncommon. However, during this 12-month trial, it enabled seamless collaboration with Occupational Therapists and Community Mental Health Nurses, offering a truly holistic and integrated service. This approach is far more effective than referring to standalone, mainstream physiotherapy services and waiting until later stages of the dementia journey.  Ultimately, early, embedded physiotherapy allows issues to be addressed proactively rather than reactively.

A successful trial but an uncertain future

The 12-month physiotherapy trial within MATS was overwhelmingly deemed a success, based on:

• Positive feedback from clients and families
• Strong support from the multidisciplinary team
• A growing number of referrals
• Alignment with current evidence, policy and best-practice standards

The conclusion was clear, specialist physiotherapy integrated into post-diagnostic dementia services is an effective early intervention that can positively impact quality of life, mobility, falls prevention and social isolation. Sadly, although the need for it to be a permanent part of the service is widely recognised, the role was discontinued due to a lack of recurrent funding. Alternative avenues of funding are continuing to be explored so watch this space.

Contributor Jackie Hodge, Physiotherapist, NHS Lothian

You can see the blog Jackie also wrote on

What does dementia rehabilitation mean to us as Allied Health Professionals? Part 1- physical health and keeping active by Jackie, a physiotherapist

here . Enjoy

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Hello, my name is Millie, and I am in my second year of the MSc Art Psychotherapy programme at Queen Margaret University. I have the privilege of being a student Art therapist on placement with Alzheimer Scotland for six months.  As an Allied Health Professional student, I am part of a wider team supporting people living with dementia in the community. My role involves offering art therapy within a day service setting. In this blog, I’d like to share a little about my role and what a typical day can look like!

Arriving and Preparing Space

A big part of art therapy happens before anyone enters the room. I prepare materials, paper, paints, clay, drawing tools, and arrange the space to feel welcoming and safe: not too many materials to overwhelm, but enough to allow opportunity for choice. Having the same room at the same time each week helps create a sense of structure and predictability. In shared settings, I’ve noticed how important it is to gently “mark out” the therapeutic space. Something as simple as a consistent tablecloth or a sign on the door can help signal that this time and space is different, and an art therapy session is about to take place. Art therapy isn’t an art class, and there’s no expectation to produce a finished piece. The materials are there as tools for expression.

Beginning the Session

Sessions may begin with a simple check-in activity. For example, a box of coloured stones can be used, inviting people to choose one to accompany a word or feeling. It’s a quiet way of arriving together and noticing what we are bringing into the room. This gentle ritual often helps build trust and a sense of safety right from the start, allowing everyone to settle into the space at their own pace. By holding something weighty yet colourful, it provides a gentle sense of presence, grounding the person in the here and now through touch and colour. At Alzheimer Scotland I facilitate both individual and group sessions, creating a contained space for exploring thoughts and feelings through art-making.

The Session – The Creative Process

The art therapy sessions take place for around 60 minutes.  During the session, people choose how they would like to work. Some may paint or draw; others may sit quietly with materials before deciding what feels right. There is no ‘right’ or ‘wrong’ way to connect with art. For people living with dementia, creativity can remain a meaningful way of connecting. Sensory engagement with colour, texture and movement can support attention and wellbeing. Art can also offer a way of expressing parts of ourselves that are harder to put into words.

Holding the Boundaries

An important part of my role is maintaining therapeutic boundaries. This includes:

• Consistent structure
• Ensuring confidentiality
• Safely storing artwork
• Receiving regular supervision

After the Session – Reflection

I take time after each session for my own quiet reflections, perhaps jotting down notes on what emerged in the artwork or interactions, or sitting with my thoughts to process the session. This personal pause supports my learning and helps me stay attuned to the experience.

As an art psychotherapy student, I also engage in regular profession-specific supervision alongside support from the Alzheimer Scotland team. This helps ensure safe, ethical practice. In supervision, I have a dedicated space to reflect deeply on each session with another professional, think about the artwork created and the interactions that unfold, and explore how best to respond in ways that honour each person’s unique experiences, strengths, and ways of being. This ongoing support helps me stay adaptable and fully focused on creating a nurturing therapeutic environment.

Working as Part of a Wider Team

Art therapy does not happen in isolation. I collaborate with daycare practitioners, coordinators, and other Allied Health Professionals. Alzheimer Scotland’s services are shaped by collaborative working and by the voices of people living with dementia, ensuring art therapy fits within a holistic and tailored approach to care and wellbeing.

Why This Role Matters to Me

As an art psychotherapy student, this placement has shown me how creativity and therapeutic support can sit alongside everyday community provision. It has reinforced the importance of creating spaces where people feel seen and heard and responding moment-to-moment to whatever emerges.

Thank you for reading! I would love to hear your thoughts.

• Have you seen creativity play a role in wellbeing?
• What questions do you have about art therapy?

Contributor. Millie Davies, 2^nd year art psychotherapy student, Queen Margaret University

Want to find out more about art therapy and dementia? Look at BAAT – the British Association for Art Therapists: https://baat.org/art-therapy/what-is-art-therapy/ and https://www.careuk.com/help-advice/art-therapy-and-dementia

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