Clone of Mindfulness for Living with Cancer

Mindfulness for people living with dementia: Eight-week course

This eight-week mindfulness course has been adapted for people living with early-stage dementia. The course consists of gentle paced two-hour weekly sessions. It starts with a pre-course orientation on 26 March at 10.30am to 12.30pm. And it then continues every week until Thursday21 May. The facilitators are: Lynn Ley and Julia Powell
If you would like help filling in this form please contact spft.smc@nhs.net. We'll arrange to call you at a time that works for you.

Otherwise, to help us support you as best we can, please complete the following questions. Most fields are mandatory - please do provide as much detail as you can. If you would like to arrange to speak with the course facilitator privately let us know and we can arrange that. The form will remain confidential to the course organiser and facilitator. Any enquiries to spft.smc@nhs.net
- Full name*
  
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- Address*
  
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- Email*
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- Please provide a second work or personal email if you'd like course information sent to both addresses:
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- Mobile number*
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- Please give us a contact name and number or email of someone we can contact if you do not attend a session and we are concerned about you? *
- GP details
  
  In the interests of your wellbeing and safety we would like permission to contact your GP to make sure that this course is appropriate for you at this time.
- Please confirm you are happy for us to contact your GP?*
  
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- GP Phone Number*
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- Please say why you want to attend this course and/or what you are hoping to get out of it?*
- The course involves: an orientation session, and eight weekly two-hour group sessions from 10.30am-12.30pm, from 26 March to 21 May. There is a suggested daily commitment of up to 20 minutes of mindfulness practice at home between sessions. Having checked all the dates and times, can you foresee any difficulties that you may have with doing this?*
  
  YesNo
- If ‘yes’, please explain
- The course invites participants to make gentle movements. These can be adapted to meet your needs. If you have any physical mobility concerns or queries, please provide details below.*
- If you have any additional needs or learning styles please let us know so we can support you.
- Is there anything else it would be helpful for us to know that might affect how you get on in the group sessions? For example, it would be important to mention: mental health issues, any recent significant stress or life events, any concerns you might have about being in a group. Even if you would rather not provide full details here, please make the facilitator aware of any issues so they can support you, as necessary, during the group sessions. If it would be helpful to talk to a facilitator, please let us know by sending an email to spft.smc@nhs.net and one of them will be in touch to arrange a convenient time to talk.*
- So we can understand how to best let people know about our work, please tell us where you heard about this training. Please tick all that apply.*
  
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Mindfulness for people living with dementia: Eight-week course

GP details