It’s a frosty Monday morning, and Jan, a graphic designer in her late fifties, arrives at the office as she has for the past 17 years. But lately, the familiar rhythm of meetings and deadlines feels heavier. Simple tasks overwhelm her, and the fear of being “found out” chips away at her confidence. Jan has early onset dementia. Yet she’s determined to keep working—not just for the salary, but for the structure, camaraderie, and sense of purpose that employment brings. She wants to choose when to step away from work, not have that decision made for her by her diagnosis.
Jan’s story is increasingly common. Dementia affects nearly a million people in the UK, and numbers are expected to rise significantly by 2040. In Scotland, this reality is being met with progressive policy responses. The Dementia Strategy for Scotland: Everyone’s Story (2023) sets out a 10-year vision for inclusive, rights-based support, co-produced with people living with dementia. It emphasises autonomy, community participation, and meaningful activity which includes employment. Similarly, Connecting People, Connecting Support in Action (2020) empowers Allied Health Professionals to help people with dementia live well, recognising the vital role of occupational therapy in maintaining client’s identity, independence, and wellbeing.
At NHS Dumfries & Galloway, we recognised a growing need to support people with dementia in the workplace. As part of a Scottish Improvement Foundation Skills project, I surveyed our local Occupational Therapy team to assess their confidence in this emerging field. Most practitioners rated themselves from “not at all confident” to “fairly confident,” revealing a clear need for targeted professional development. More significantly, we identified a service gap: no standardised resource existed to support individuals with dementia who wished to remain employed.
In response, I developed a Memory Strategies for Work booklet which is a practical guide designed to support both practitioners and clients. It helps individuals identify their strengths and challenges, offers tailored coping strategies for workplace demands, and includes a personalised reasonable adjustment plan. The booklet also provides psycho-education on the cognitive benefits of continued employment and links to further resources for clients, carers, and employers. Importantly, it also encourages the exploration of alternative roles such as part-time work, less cognitively demanding tasks, or volunteering thus preserving the individual’s identity as a worker while adapting to change.
We’re currently piloting the booklet locally and are in the process of gathering feedback from Occupational Therapy staff, clients and carers. Early signs are promising. If successful, we aim to share it across additional Health Boards to scale support nationally.
This project reflects the principles of Scotland’s national dementia policies, translating them into tangible support that empowers individuals to remain at their work.
Jan’s story is not unique and cases are set to become more prominent as dementia diagnoses rise as more people are diagnosed earlier in life, the need to support individuals in maintaining employment will become increasingly central to occupational therapy practice. As Occupational Therapists we can support people with dementia to remain employed, stay connected, and feel empowered.
Contributor: Julie Baldotto, Specialist Mental Health Vocational Occupational Therapist, NHS Dumfries & Galloway