This is me

Supporting patients with dementia

Someone who has dementia, delirium or other communication difficulties, can find changes, such as moving to an unfamiliar place or meeting new people who contribute to their care, unsettling or distressing. 

The “This is Me” document provides information about the person at the time the document is completed. It can help our staff build a better understanding of who the person really is and helps us to provide care that is person centred. It is especially important at the moment where there may be restrictions on visiting.

If you have a relative with dementia in hospital, please do complete the form below. It should be completed by the individual(s) who know the person best and, wherever possible, with the person involved. Please read the guidance notes on filling in the form. If you have any questions, please contact the Dementia team on 01634 975954 or email


About me

My background

My habits and routines

My communication and mobility

My personal habits


This form was created using the Alzheimer’s Society 'This is me' leaflet