SAFER-Dem: generating co-designed adaptations to a discharge care planning bundle for people living with dementia

Tyler, N, Harbinson, G, Giles, SJ, Bifarin, O ORCID: 0000-0002-8247-2508, Parveen, S, Robinson, C and Panagioti, M (2026) SAFER-Dem: generating co-designed adaptations to a discharge care planning bundle for people living with dementia. BMJ Open, 16 (3). pp. 1-11. ISSN 2044-6055

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Abstract

Objectives: To gather insights from people living with dementia, unpaid carers and professionals to co-design and refine a dementia-inclusive adaptation of the SAFER-Mental Health discharge care bundle, SAFER-Dem, that addresses challenges in the discharge process from mental health inpatient settings. A secondary objective was to assess how stakeholders interact with and understand the revised materials, focusing on usability and the perceived effectiveness of the dementia-inclusive adaptations.

Design: Qualitative co-design study involving sequential workshops and ‘think-aloud’ usability interviews, guided by participatory design and cognitive interviewing methods.

Setting: Mental health inpatient settings in the UK.

Participants: 17 stakeholders (nine people with lived experience as a person living with dementia or carer and eight healthcare professionals) took part in four co-design workshops. 12 additional stakeholders (four people living with dementia, four unpaid carers and four professionals) participated in ‘think-aloud’ interviews. Participants were recruited via NHS Trust networks, advisory groups and social media.

Results: Participants highlighted widespread dissatisfaction with current discharge procedures, especially communication failures and environmental barriers. Changes to SAFER-Dem included simplified materials, flexible timing of delivery, realistic imagery and additional aids such as scenario cards and talking mats. Three main usability themes emerged: appropriateness, practical changes and usability.

Conclusions: The SAFER-Dem care bundle was well received by stakeholders, showing promise for improving discharge quality for people living with dementia. Participants identified areas for improvement to enhance accessibility and effectiveness. Findings suggest that with further evaluation, SAFER-Dem could become a valuable tool in supporting dementia-inclusive discharge practices. Research and co-design with people living with dementia have been instrumental in understanding experiences during discharge.

Item Type:	Article
Uncontrolled Keywords:	PSYCHIATRY; MENTAL HEALTH; Health Services; Humans; Dementia; Patient Discharge; Qualitative Research; Aged; Caregivers; Female; Male; Interviews as Topic; Patient Care Bundles; United Kingdom; Stakeholder Participation; Health Services; MENTAL HEALTH; PSYCHIATRY; Humans; Dementia; Patient Discharge; Qualitative Research; United Kingdom; Female; Male; Caregivers; Patient Care Bundles; Interviews as Topic; Aged; Stakeholder Participation; 4203 Health Services and Systems; 4205 Nursing; 42 Health Sciences; Neurodegenerative; Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD); Dementia; Clinical Research; Brain Disorders; Neurosciences; Aging; Social Determinants of Health; Health Services; Acquired Cognitive Impairment; Behavioral and Social Science; 8.1 Organisation and delivery of services; 7.1 Individual care needs; Neurological; 3 Good Health and Well Being; 1103 Clinical Sciences; 1117 Public Health and Health Services; 1199 Other Medical and Health Sciences; 32 Biomedical and clinical sciences; 42 Health sciences; 52 Psychology
Subjects:	R Medicine > RT Nursing
Divisions:	Nursing and Advanced Practice
Publisher:	BMJ Publishing
Date of acceptance:	24 February 2026
Date of first compliant Open Access:	16 April 2026
Date Deposited:	16 Apr 2026 10:41
Last Modified:	16 Apr 2026 10:41
DOI or ID number:	10.1136/bmjopen-2025-109677
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28379

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