When individuals hear the word ‘frailty’ they may often think about decline in physical health, falls or mobility difficulties. While these can certainly be part of my role, being a Frailty Practitioner is much more than managing symptoms. It is about getting to know the whole person and supporting them to continue to live well, in whatever challenges they may face.
As an Occupational Therapist (OT) by background, I have always been interested in supporting people to maintain independence and engage in meaningful occupations. In my transition into Frailty, this has allowed me to build on these skills and work more holistically with older adults, including many people living with dementia and their families.
Starting the Day
No two days are ever the same.
My day usually begins by reviewing referrals from the Integrated Front Door Services. These referrals may come from the Emergency Department (ED), Acute Assessment Unit, Urgent Care, Hospital at Home, Inpatients or from the Scottish Ambulance Service.
Often, the people I meet may experience a combination of challenges. This could include a decline in memory, a recent fall, or a change in managing everyday tasks. As part of my assessment, I take time to understand their medical history, current concerns, and most importantly what matters to them. A Comprehensive Geriatric Assessment is completed with the multidisciplinary colleagues, where we aim to identify what matters most to the individual and address any immediate unmet needs and ensure the right supports are in place to help them return home safely wherever possible.
Meeting people where they are
A significant part of my role involves meeting people where they are in their journey, whether that’s in their own home or within the hospital setting.
Some days, I visit people at home to understand how they manage their familiar environment. For people living with dementia, remaining in familiar surroundings can be especially important, as routines, memories and a sense of security are closely connected to home.
At other times, I work within the hospital setting, supporting efforts to avoid unnecessary admissions and facilitate timely discharge. Often, hospital admission can be a challenging and disorientating experience for someone living with dementia and can carry risks of further deconditioning during prolonged hospital stays.
Regardless of the setting, the focus remains the same – to understand what matters to the person, what their strengths, goals and circumstances are, rather than solely considering their diagnosis or medical condition.
The importance of seeing the whole person
One of the most rewarding aspects of my role is taking a person centred approach. A diagnosis of dementia does not define a person; everyone has their own story and experiences.
When working with people living with dementia, I consider not only their physical health but also how cognition, confidence and social connection and the home environment impacts daily life.
Small changes can often make a big difference. This might involve introducing strategies to support memory, provision of equipment for safety, adapting routines to reduce stress, or signposting to local support services.
Supporting Families and Carers
Frailty and Dementia doesn’t just affect one person. It can have a significant impact on partners, family members, and carers. Many carers provide extraordinary levels of support whilst balancing their own commitments. Part of my role is listening to their concerns, helping them access support, and ensuring they feel involved.
Working together
No one professional can meet every need of a person. That’s why collaboration is an important part of my role. I work closely with General Practitioners (GPs), Nurses, OTs, Physiotherapists, social care, and third-sector colleagues. Together, we aim to provide coordinated support to help people maintain independence and improve quality of life. This can support ensuring those living with dementia receive the right support at the right time.
What I love most about my role
The role can be challenging yet incredibly rewarding. Some of the most meaningful moments come from helping someone continue to do something they love and regain confidence after a setback. My occupational therapy background continually reminds me to focus on what brings purpose and meaning to people’s lives. As a Frailty Practitioner, I can combine that perspective with a broader understanding of health, wellbeing, and ageing.
Looking Ahead
As our population ages, supporting people to age well whilst living with frailty and dementia is becoming increasingly important. Early intervention, person centred care and strong community connections all play a crucial role. Every day, I am reminded that frailty is not simply ageing. It is about understanding the person behind a health condition, recognising what works for them, and working together to help them continue to live the life they want to lead. In doing so, this can support someone living with dementia from a health, identity, and independence perspective.
Key take home messages:
Frailty is not a negative label or an inevitable part of ageing. It helps us to understand when someone may need extra support to continue to age well and do the things that matter most to them. Whether at home or in hospital, my role is about helping people to maintain independence where possible. Because frailty doesn’t define a person, neither should Dementia.
Contributor: Amber MacVicar, Occupational Therapist/Frailty Practitioner, Western Isles
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