Too often, these journeys begin in distress and end in escalation, because the system wasn't designed with dementia in mind.

We decided to change that.

The starting point: At home or in care

Every dementia journey begins somewhere, often in a nursing home, residential setting, or family home. It might be a scheduled appointment, or it might be an emergency call.

Wherever it begins, this is our first opportunity to shape the experience.

That’s why we’ve introduced our localised dementia support booklet at this earliest stage. If the individual is being picked up by a patient transport vehicle or ambulance, the crew either already has the booklet or receives it from the care setting.

This simple, accessible resource provides immediate information on local services and support, images of localised areas for reminisce, images of the staffing team involved with the journey, and acts as a communication tool for staff to use alongside the patient during the journey. Its familiar imagery and gentle tone also offer comfort and orientation reassurance at a moment when confusion is often already setting in.

Stress often starts before the vehicle moves. Our booklet helps everyone involved feel better prepared from the first moment.

The journey: Inside the vehicle

Once in the vehicle whether a patient transport vehicle or emergency ambulance the environment becomes critical. For someone living with dementia, confined spaces, unfamiliar faces, and sudden movement can quickly lead to fear, agitation, or even aggression.

We’ve redesigned that environment.

Our vehicles now include localised imagery, familiar landmarks, calming colours, and gentle cues that help patients feel more grounded. We’ve added calming music or conversation prompts based on local history and known preferences. These seemingly simple additions are rooted in evidence and empathy, they reduce sensory overload, provide points of connection, and allow patients to stay calmer and more engaged.

A calmer journey means a better outcome. Reduced anxiety improves communication, reduces escalation, and leads to a smoother arrival, whether for emergency care or a routine appointment.

Impact on patient and staff safety

One of the key aims of these adaptations is to create a calmer and more reassuring experience for patients during transit.

For individuals living with dementia, changes in environment, unfamiliar settings, and communication challenges can sometimes lead to heightened anxiety or distress.

By proactively designing for comfort and familiarity through calmer surroundings, local imagery, and simplified communication tools we aim to reduce these triggers and promote more positive interactions.

While formal data collection is ongoing, early observations suggest that these changes may support smoother, more settled journeys for patients. Staff have also reported that the tools feel useful and appropriate for the challenges they encounter during dementia-related journeys.

A thoughtfully designed journey has the potential to ease distress and improve the experience for everyone involved.

The destination: Emergency or appointment

When the patient arrives whether at a hospital outpatient department, a diagnostic clinic, or A&E they may be calmer, more oriented, and feel better supported.
In emergency settings, this could support quicker assessment and a less stressful experience. For appointment-based journeys, patients may be more receptive and settled, which can make a real difference in engagement and comfort. The booklet also travels with them, offering helpful context for receiving teams and reinforcing a person-centred approach.

Too often, people with dementia arrive at care settings already overwhelmed. These small but intentional changes may help improve that first impression and support a more effective and compassionate interaction.

Trial and feedback: Welsh Ambulance Services NHS Trust (WAST)

We’re proud to have trialled the full dementia care journey with the Welsh Ambulance Services NHS Trust (WAST), integrating the booklet and ambulance adaptations into live practice.

While formal evaluation is ongoing, initial informal feedback has been encouraging. Staff have noted that the resources feel practical and easy to use, and there is early indication that these changes are being well received by both teams and carers.

While we are still in the early stages of implementation, these changes have been developed with the goal of improving interactions, reducing visible distress, and better supporting both patients and staff. The use of tools like the booklet and familiar imagery is intended to provide reassurance and help make journeys feel more personalised and less overwhelming. Feedback so far suggests that staff and carers see potential in this approach, particularly in how it may help address emotional needs that are often overlooked during transport.

Looking ahead: Dementia-friendly A&E bays

We’re working toward the creation of dementia-friendly A&E bays designed around the same principles. These spaces will include localised imagery to reduce disorientation, calm and controlled lighting to minimise sensory overload, and access to our booklets and music tools to provide familiarity during wait times.

We believe the journey doesn’t end at the hospital door. It continues in corridors, bays, and waiting rooms. And we believe every space should be dementia informed.

A complete dementia journey

From the moment the vehicle pulls up to the moment care is handed over, every part of the journey could now be better.

We’ve introduced a booklet that empowers, a vehicle environment that calms, a route that potentially prevents escalation, and a destination that continues the care not resets it.

We’ve stopped treating the journey as a gap between services. We now see it as part of the care itself.

A call to transform

What we’ve built is more than an initiative. It’s a new way of seeing dementia in healthcare not as a disruption to the system, but as something the system can adapt for, prepare for, and truly support.

Imagine if this was standard. Not the exception.

Imagine booklets in every vehicle, calm and localised environments in every ambulance, and dementia-friendly bays in every A&E. Imagine care journeys that heal instead of harm.

We’ve made it real. And we’re ready to help others do the same. Because every dementia journey deserves to begin and end with dignity, clarity, and compassion.

About the author

James Maddocks is a healthcare innovator and proactive systems thinker at Radwraps Healthcare Solutions. He specialises in person-centred dementia care and service design. In collaboration with the Welsh Ambulance Services NHS Trust, James has led the development of practical, empathy-driven tools that improve the dementia journey from home to hospital. His work focuses on frontline usability, staff safety, and scalable, real-world impact.