Most ambulances can be disorienting places at the best of times, but if someone is living with dementia, a trip in an ambulance can be stressful enough to escalate agitation and make quality care more difficult. Ambulance Victoria's Lindsay Bent is advocating for a solution.
Sinister machinery, confusing furniture and a floor made of water – these are just some of the impressions a traditional ambulance might make on a person living with dementia.
Not only that, but paramedics in Australia – while educated in a very wide array of health conditions – receive no specific training in dementia, meaning they may not understand the fear or agitation that could result from pain, confusion and an unfamiliar environment.
But on the other side of the world, in the UK, they’ve been doing something about it.
Dementia-enabling ambulances have become a reality in Yorkshire, introduced last year in line with a National Health Service push for better training and spaces to accommodate people living with dementia.
Lindsay Bent, Clinical Lead for Ambulance Victoria’s Communications Centres, observed their development as part of a 2022 Churchill Fellowship study program.
“It's often the simple modifications to these vehicles that can make some really big differences,” Lindsay said, speaking as part of a First Responders panel at the International Dementia Conference 2024 in September.
'It's often the simple modifications to these vehicles that can make some really big differences.'
He elaborated on the thoughtful modifications that have brought a more enabling experience to patients living with dementia, beginning with the floor.
“The floor isn’t blue anymore - it's now grey, because blue can be interpreted as water,” he said.
“Or it can even be perceived as the sky - someone told me about the story of a World War II fighter pilot who refused to get out of bed in their aged care home because their carpet was blue, and they had this vision that they were being shot out of the sky.”
The ambulance’s interior colours were switched to ones with better contrast, and yellow piping around the seating makes the edges clear to assist with visual orientation.
Tiger striping was added at the entrance to make it more obvious. Distracting medical machinery is tucked away in a cupboard, out of the patient’s eyeline.
The insides of the window blinds are printed with scenes of the Yorkshire moors, a familiar backdrop for most passengers.
“The patients instantly recognise it and it's calming,” said Lindsay. “It provides a talking point.”
Patients are provided with a tablet device for ‘reminiscence therapy’, where old videos of the past play as a distraction, and knitted fiddle toys serve to provide comfort and to prevent restless hands playing with the seatbelt.
When they start on the job, paramedic staff are put through dementia training of varying degrees.
Lindsay also praised degree courses in UK universities that incorporate dementia training, singling out Sterling University’s Being Dementia Smart program.
“It's supported by a simulation centre within the university as well and gives an incredible amount of knowledge, skills and ability for that student paramedic to come out with,” Mr Bent said.
While dementia-friendly ambulances would be a great start, Lindsay wants to see an even bigger shift across the whole community's approach to dementia.
While dementia-friendly ambulances would be a great start, Lindsay wants to see an even bigger shift across the whole community's approach to dementia.
“I would really love to see direct leadership from the federal level downwards to the states, making dementia a priority not just within health but across the community,” Lindsay said.
The Australian Government has recently released a National Dementia Action Plan, which aims to improve and integrate “policies, services and systems for people living with dementia, their families and carers”, but Lindsay hopes to see further change across society.
“The challenge is that we all must become dementia-friendly,” he said, pointing to the UK’s 2009 National Dementia Strategy as a model that led to change in many sectors, not just healthcare.
“If we have a look at the UK experience, when they elected to become dementia-friendly on the back of the Prime Minister's commitment to dementia, it was not just the health system that responded.
“It was also a lot of public bodies – libraries, for example, created dementia action plans.
“And these organisations modified their own environments to be dementia-friendly, and educated their staff, so that when people who live with dementia come into, say, a museum, they can look after them a little bit better and give them an experience that is more meaningful to them.
“So, it's actually broader than just healthcare - it's across the community.”
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Author: The Dementia Centre
Read time: 3 min. read
