What should go in a dementia hospital passport?

A dementia hospital passport can include routines, communication needs, comfort items, family or carer contacts, distress triggers, and information that helps staff support the person well.

How can a dementia passport help in hospital?

A dementia passport can help staff understand the person more quickly, reduce repeated explanations, support familiar routines, and identify what may reduce distress.

Can a family member or carer complete a dementia passport?

Yes. A family member, carer, or support worker can help complete the passport and share details that help hospital teams provide more personalised care.

Is it useful for planned and emergency admissions?

Yes. A dementia hospital passport can be useful in planned admissions, emergency admissions, hospital visits, ward stays, and discharge planning.

Dementia Passport

by Know Me

Share what matters most so staff can support you in the right way.

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Prefer a paper or offline version?

Download a blank Know Me template to type into offline or print and complete by hand.

Choose an Image Style

Realistic

Illustrated

Easy on the i

No Images

About Me

My name is

The name I like new people I meet to use Required

My date of birth is

Day

Month

Year

My NHS number

What is your preferred language?

What I want you to know first

The area where I live and how long I have lived there

The people important to me are

How I like to be contacted

Phone call

Text

Through someone else

Things I like to talk about

My Life

My personal history, family and friends

My important items

My religion, culture or beliefs

My hobbies and interests

My jobs and achievements

Favourite places I have lived and visited

My Daily Life

The routines that are important to me

Things I like to do for myself

Things I might want help with

My personal care

Things that help me sleep

How I take my medication

My eating, drinking and dietary needs

List any dietary requirements, food preferences or speech and language advice

These are example options. Select the ones that are right for you.

Peg or tube fed

I have a plan from a healthcare professional

I need adapted cutlery or plates

I have restricted foods

I like to eat in private

Supporting Me in Healthcare

How I communicate and what support helps

These are example options. Select the ones that are right for you.

My hearing and eyesight

How do you mobilise?

Independently

With support

Things that may worry or upset me

What helps me if I am anxious or upset

I need information shared with me in this way

These are example options. Select the ones that are right for you.

Easy Read

Written down

Email summary

Pictures

Symbols

Add your own

When communicating, these reasonable adjustments will help me

These are example options. Select the ones that are right for you.

Please talk slowly and clearly

Please give me time to respond

Talk me through procedures slowly, step by step

Please write down the key points I need to remember

Give clear instructions with time frames

Use a now and next approach

Keep me updated if things change

Add your own

Reasonable adjustments I need accessing healthcare

These are example options. Select the ones that are right for you.

Longer appointments

Minimal waiting time

Quiet waiting area

Side room

Step-free or wheelchair access

Add your own

How to help me during tests, examinations or medical procedures

These are example options. Select the ones that are right for you.

Distraction

VR headset

iPad or tablet

Music

Small talk

Silence

Step by step guide

Add your own

Have you ever had a blood test?

Is there anything else a healthcare professional should know about you so they can support you better

Sending and Local Information

Your address

Your postcode

We use your postcode to show local information.

Email address

Add your email address to receive your health passport

Tick this box to get emails from Know Me, like a reminder to update your health passport. You can stop these emails at any time.