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Supporting IPC in people who ‘walk with purpose’

The Scottish Government has issued advice on infection prevention and control for people with dementia who ‘walk with purpose’.

The guidance advocates risk assessment in this resident group that considers the prevention of stress and distress caused by isolation in addition to IPC requirements. It also provides some advice to support care in the home.

However, as general guidance:

  • sedation or restraint should not be used, in any circumstances, to enforce compliance with isolation or infection prevention and control measures
  • care homes should consider the specific additional support, meaningful activities, and/or one-to-one care which may be necessary to support the person’s needs
  • Occupational therapists and community mental health teams may be able to provide useful advice about using meaningful activity to help support residents who walk with purpose within infection control zones
  • if individuals are unable to cope with isolation, additional PCR testing may be considered between days five and seven of isolation. However, it is important to note that people living with dementia or with cognitive decline may not cope with a test (and with the subsequent isolation) which is invasive, and this could lead to distress.  
  • a negative test does not remove the need for continued vigilance for symptoms of COVID-19 infection.  Staff should be alert to changes in the resident that could indicate infection including the more atypical signs. Refer doubts and concerns to the local health protection team.   

Details on when residents should isolate, the length of which and when isolation can be discontinued can be found in Public Health Scotland Guidance ‘COVID-19: Information and Guidance for Care Home Settings (Adults and Older People


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