Post-Diagnostic Support for Dementia in Scotland: The 5-Pillar Model and Link Workers

Scotland is the only part of the UK that guarantees a minimum of one year of dedicated, structured support after a dementia diagnosis. If your parent has just been diagnosed, this is the most important support system to activate — and many families miss it because no one tells them it exists.

What Is Post-Diagnostic Support?

Under the Scottish Local Delivery Plan Standard, everyone newly diagnosed with dementia in Scotland is entitled to at least 12 months of support from a trained Link Worker. This is not a helpline or a leaflet — it is ongoing, structured, one-to-one support tailored to your parent and your family.

The Link Worker is typically employed by the NHS, the local Health and Social Care Partnership, or Alzheimer Scotland, depending on the area. They work through the Alzheimer Scotland 5-Pillar Model of Post-Diagnostic Support.

The 5 Pillars

Pillar 1: Understanding the illness. Your parent and family receive education about the specific type of dementia diagnosed, what symptoms to expect, available treatments, and coping strategies. This is practical, not academic — it covers things like managing medication side effects and adapting daily routines.

Pillar 2: Community connections. The Link Worker helps your parent stay connected to activities, hobbies, and social networks. Isolation accelerates cognitive decline, so maintaining community engagement is a genuine clinical priority, not just a nice-to-have.

Pillar 3: Peer support. Connection with other people living with dementia and their families — through local dementia cafés, support groups, and peer networks. Hearing from someone six months ahead of you on the same path is often more useful than any professional advice.

Pillar 4: Planning for future decisions. This is the pillar families most often wish they had engaged with earlier. The Link Worker helps your family think about legal and financial planning — specifically, setting up Power of Attorney while your parent still has capacity, and discussing who will make decisions if capacity is lost.

Pillar 5: Planning for future care. Anticipatory care planning: recording your parent's preferences for where and how they want to be cared for as the condition progresses, and preparing for potential crises like hospitalisation or the need for residential care.

How to Access It

The referral should happen automatically after diagnosis, either through the memory clinic or the GP. If several weeks have passed and no one has been in touch, call your parent's GP practice and ask them to arrange the Link Worker referral. You can also contact Alzheimer Scotland directly on their helpline (0808 808 3000) to be connected to local post-diagnostic support.

Getting the Most from the 12 Months

The support is time-limited, so use it strategically. The most impactful actions to complete during the 12-month window:

• Get Power of Attorney drafted, signed, and submitted for OPG registration
• Complete an Anticipatory Care Plan and ensure it is recorded on the Key Information Summary
• Claim Pension Age Disability Payment if your parent is eligible
• Request an Adult Carer Support Plan for yourself as the family carer
• Identify and trial local support services (day care, sitting services, peer groups) before they become urgent

After the 12 months, ongoing support varies by area. Some health boards extend the Link Worker relationship; others transition to community groups or voluntary sector services.

Our Scotland Dementia Care Guide includes a post-diagnostic action plan with timelines mapped to the 5-pillar framework.

See more Scotland guides →