Working together

Angela finds new ways to support patients with dementia

Angela Moore knows how important support from family carers can be for patients with dementia. That’s why she’s introduced a carers’ passport where she works at Hinchingbrooke Hospital in Huntingdon.

As an Admiral Nurse, or specialist dementia nurse, she’s seen how passports help reduce anxiety for patients as well as making it clear to carers that they are welcome and valued.

Using the passport scheme, family members are encouraged to stay throughout their relative’s admission. They’re given a hospital badge that clearly identifies them as a carer and allows staff to see, at a glance, they have permission to visit at any time.

Carer badge

An example of a hospital badge worn by carers

“We recognise that this may be one of the few chances carers have for some respite but they’re a valued part of the team and if they want to be involved they can be. It means we might have to have a few more discussions but this all helps us provide the best care for the patient,” says Angela.

When an older adult with dementia is admitted to acute care, family carers are an important source of information. Angela says it makes a big difference when carers are involved in providing care, communicating with patients and discharge planning. She’s made her work a multidisciplinary project by getting doctors on board too.

Carers are able to be part of the decision-making process

“When a patient is admitted, a carer’s role changes and they may feel excluded from care and decision making even though they may have been giving the majority of care to the patient at home,” she says. “But by improving our communications with carers, they’re better able to understand the goals of care and be part of the decision-making process.”

But introducing the scheme hasn’t come without challenges, as Angela explains. “We say relatives can stay but some staff have questioned how this can work with the traditional ‘two to a bed’ visiting rule. Some staff initially saw the carers’ presence as an intrusion. But they soon saw that having them there improved care beyond anyone’s expectations.”

Quality of life

Angela has also addressed the lack of knowledge, training and equipment in her workplace, which she felt was having an impact on the way staff were able to communicate with patients with dementia. She successfully applied for charitable funding through the Friends of Hinchingbrooke to improve the patient’s environment.

As a result, new facilities and activities have been introduced and quality of life has taken centre stage. The day room has been decorated and moved to the middle of the ward and a new, bigger table has been brought in for more social dining. “It’s lovely to see people sat talking, dining, knitting, and sewing,” says Angela. “And there’s been a huge improvement in patients' nutrition and wellbeing.”

Spreading the word

Angela says working as an Admiral Nurse has provided her with an opportunity to work at an advanced level and focus on her passion to improve dementia care. But not satisfied with the overhaul of care she’s introduced into her workplace, she’s recently taken her message to the Women’s Institute who have thrown their weight behind this work too. She’s also an ambassador for John’s Campaign, a charity that campaigns for easy access to carers for patients with dementia who are admitted to hospital.

Angela Moore on ward

Admiral Nurse Angela Moore

Angela’s support for her patients and their carers recognises the vital role carers can play and that they are more than simply visitors. “When children are admitted to hospital, no-one questions that their parent should continue to look after them. Why not for others? They’re an essential part of the patient's support team,” she says.

Dawne Garrett, RCN Professional Lead for Care of Older People and Dementia, says the College has been a long-standing supporter of Admiral Nurses and John’s Campaign. “The work that Angela and other Admiral Nurses do is vital for the care and wellbeing of many people,” she adds.

What is an Admiral Nurse?

Admiral Nurses are specialist dementia nurses who give expert practical, clinical and emotional support to families living with dementia. The support they provide to families enables them to make informed choices and decisions. Admiral Nurses also act in a consultancy role, educating generalist staff to recognise advanced and end-of-life care in dementia. 

There are fewer than 200 Admiral Nurses in the UK and Angela is one of just 10 working in acute care. Find out more at Dementia UK. 

Did you know?

  • Patients with dementia stay in hospital twice as long as other patients.
  • 88% of carers said either no hospital staff or only some understood the needs of people with dementia. 
  • Age and complexity increases the risk of admission to acute care.
  • Compared with other patients people with dementia are at higher risk of poorer health outcomes.
  • Family carers of people with dementia are their most important support in practical, personal and economic terms.


Find out more

Take a look at the RCN's online dementia resources or join the RCN Older People's Forum to network with nursing colleagues working in the specialty.

Words by Sharon Palfrey / Pictures by Tim George

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