Dementia at the Front Door: Rethinking Emergency Care for People Living with Dementia and Their Carers
Parallel 1
17 November, 2026 12:00 – 1:10 pmMini Presentations Group 1
Kathryn Fry
Service Development Lead for Dementia and Delirium Services
Kingston and Richmond NHS Foundation Trust
Amel Guechdi
Admiral Nurse in ED
Kingston and Richmond NHS Foundation Trust
Summary
Emergency Departments (EDs) are a critical point of contact for people living with dementia and their carers. The environment is often busy and can influence how people with dementia experience care, including increased distress or confusion. Encounters are often brief but carry significant importance for understanding the needs of both the individual and those around them. This raises an important question: are we asking the right questions in emergency care?
Within Kingston and Richmond NHS Foundation Trust, the introduction of an Admiral Nurse role within the Emergency Department has provided a new approach to supporting people living with dementia and their carers at the point of presentation. This work has focused on rethinking how dementia care is delivered at the ‘front door’, with an emphasis on improving experience and supporting staff to respond effectively within a complex clinical environment.
This presentation outlines the development of this service and reflects on what has been learned through embedding dementia expertise within an acute setting. Through clinical practice, staff engagement and real-world case examples, we highlight the importance of recognising the wider context of each patient’s life alongside their immediate clinical needs, supporting a more person-centred approach to care.
A key insight from this work has been the identification of carers whose roles may not be immediately visible, particularly individuals who attend the Emergency Department while continuing to support someone living with dementia at home. These situations highlight important considerations around risk, decision-making, and continuity of care, and demonstrate how small changes in questioning and awareness can support more holistic and informed responses.
Evaluation is based on qualitative feedback from staff and patient and carer interactions, alongside reflections on changes in practice. This includes improved identification of need, more informed decision-making, and strengthened links with community services. We also reflect on the realities of embedding this approach within everyday practice, including time pressures, competing priorities, and limitations in accessing support outside of normal working hours.
We conclude with key learning for other services, emphasising the role of the Emergency Department as an important point of opportunity to ask the questions that enable safer, more connected, and more responsive care for people living with dementia and those who support them.