Co designed intervention shows promise for improving mental health discharge for people with dementia, research finds
A new tool designed to support people with dementia when being discharged from mental health hospitals has been co‑designed and evaluated by researchers at Թϱ. The SAFER‑Dem intervention shows promise as an effective, patient‑centred approach to improving the discharge process, aligning care with best practice guidance while addressing the specific needs of people with dementia.
Published in the journal , the study shows that SAFER‑Dem is highly inclusive and has the potential to provide safer, more coordinated transitions from hospital to community care, which supports the goals of the NHS 10‑Year Health Plan for England.
The study is funded by the National Institute for Health and Care Research (NIHR) Three Schools Dementia Career Development Award and the .
Care bundles are a set of practical, evidence‑based interventions designed to improve the quality and safety of care for patients. The NHS Improvement SAFER patient flow bundle, for example, is a practical tool designed to reduce delays and improve patient safety in adult inpatient wards. The research team had already developed a care bundle called SAFER‑Mental Health (SAFER‑MH), which is an adapted version of the NHS SAFER patient flow bundle tailored to the specific needs of mental health settings.
By applying a co-designing approach, researchers worked with participants to redesign SAFER‑MH into a clearer, simpler, and more dementia‑inclusive version, the SAFER-Dem.
, Research Fellow at the University of Թϱ, who led the study, said: “People with dementia often have difficult experiences when discharged from mental health hospitals. Many feel confused, unheard, or not involved in decisions about their own care. Staff also report challenges, such as lack of time, unclear communication and busy ward environments.
“We worked directly with people living with dementia, unpaid carers, and healthcare professionals to help improve the discharge process from hospital to community for people with dementia. Our study participants took part in workshops and interviews, where they tried out early versions of the SAFER‑Dem materials and gave feedback. Altogether, 29 people participated.”
We worked directly with people living with dementia, unpaid carers, and healthcare professionals to help improve the discharge process from hospital to community for people with dementia. Our study participants took part in workshops and interviews, where they tried out early versions of the SAFER‑Dem materials and gave feedback.
Participants agreed that current discharge processes are often poor. Common problems included unclear communication, not receiving enough information, difficulty navigating busy environments, and a lack of involvement in planning. Medication information was a particular concern. As a result of the workshops and interviews, key changes were proposed to refine the dementia-inclusive discharge care bundle.
Overall, participants felt that SAFER-Dem could help improve conversations, support shared decision‑making, and make the discharge process feel more person‑centred. However, they noted that people with more severe dementia may need more support or may not always be able to use the materials independently.
Co-author Professor Maria Panagioti from Թϱ said: “Our study shows that by improving the quality and consistency of discharge planning, SAFER-Dem has the potential to enhance patient safety, strengthen system resilience, and support more timely discharges where appropriate. It may also help reduce avoidable readmissions by ensuring that patients leave hospital with the right support in place.
“The SAFER-Dem intervention is not just about speeding up discharge, but about improving how discharge is delivered—making it safer, more personalised, and more effective for both patients and the wider health system.”
The researchers concluded that SAFER‑Dem shows real promise for making discharge from mental health inpatient care safer, clearer, and more inclusive for people living with dementia. Further evaluation and testing will help determine how SAFER‑Dem can be scaled across mental health services.
- The paper SAFER-Dem: generating co-designed adaptations to a discharge care planning bundle for people living with dementia, published in the BMJ Open is available . DOI: