In 2024/25, I had the opportunity to work for 12 months within the Memory Assessment and Treatment Service (MATS), supporting people following a diagnosis of dementia. As a specialist mental health physiotherapist, this role allowed me to work alongside a multidisciplinary team to provide early, person-centred post-diagnostic support.
My core aim was simple but powerful: to help people living with dementia build and maintain a meaningful life through physical activity. This support wasn’t just about treatment — it was about self-management, wellbeing and preserving independence at a time when people are often feeling overwhelmed and uncertain about the future.
Pattern we can change
I have worked as a physiotherapist in mental health for over 25 years. During that time, I have seen how dementia can negatively affect mobility, often leading to what is known as the “shrinking world phenomenon” — where a person’s world gradually becomes smaller until they may become isolated or housebound. But this trajectory need not be inevitable.
People living with dementia can gain enormous benefit from remaining active, engaged and visible in their communities. Being out in public, visiting stimulating environments and maintaining social connections all contribute to cognitive stimulation, physical health, and emotional well-being. This is where physiotherapy plays a vital role — encouraging movement, supporting confidence and enabling participation in meaningful everyday activities.
Why early physiotherapy makes a difference
Seeing people at the post-diagnostic stage is key. Early physiotherapy input allows us to embed
falls prevention strategies, mobility support and self-management skills at a time when individuals and their carers are often more motivated, receptive and open to guidance.
A dementia diagnosis can be frightening and emotionally challenging. As a mental health physiotherapist, I bring both clinical expertise and a deep understanding of the psychological impact of the condition. This allows me to introduce physical activity as a management tool in a professional, empathic and achievable way, tailoring interventions to suit the individual’s needs, physical and cognitive abilities and priorities.
What does post-diagnostic physiotherapy look like?
During the 12 month trial, interventions varied depending on the individual, but commonly included:
- Falls risk assessment and prevention advice
- Equipment and home adaptations to improve safety
- Assessment of outdoor mobility and improving confidence
- Walking aid provision
- Individually tailored home exercise programmes
- Referral to community-based exercise groups, such as Movement for Memories in Edinburgh
- Signposting to other relevant services
The focus was always on what matters to the person – helping them continue to do the things they enjoy for as long as possible.
Outcome of the trial
Feedback from individuals and families consistently highlighted the positive impact of physiotherapy input — particularly the sense of reassurance, confidence and hope it provided.
Some of the comments received included:
“I really do think this has helped my dad and has put my mind at rest that we are doing all we can to help him.”
“The physio noticed areas of concern we hadn’t seen and suggested helpful equipment and exercises. This has given my dad confidence and me reassurance.”
“This visit was the most useful thing we have had since her diagnosis.”
“I felt understood and supported at my own pace. I’m now doing my exercises and starting to go out more.”
These reflections reinforce the value of early, specialist physiotherapy in shaping a more positive
post-diagnostic journey.
A missing piece in dementia services
Physiotherapy input within MATS is still relatively uncommon. However, during this 12-month trial, it enabled seamless collaboration with Occupational Therapists and Community Mental Health Nurses, offering a truly holistic and integrated service. This approach is far more effective than referring to standalone, mainstream physiotherapy services and waiting until later stages of the dementia journey. Ultimately, early, embedded physiotherapy allows issues to be addressed proactively rather than reactively.
A successful trial but an uncertain future
The 12-month physiotherapy trial within MATS was overwhelmingly deemed a success, based on:
- Positive feedback from clients and families
- Strong support from the multidisciplinary team
- A growing number of referrals
- Alignment with current evidence, policy and best-practice standards
The conclusion was clear, specialist physiotherapy integrated into post-diagnostic dementia services is an effective early intervention that can positively impact quality of life, mobility, falls prevention and social isolation. Sadly, although the need for it to be a permanent part of the service is widely recognised, the role was discontinued due to a lack of recurrent funding. Alternative avenues of funding are continuing to be explored so watch this space.
Contributor Jackie Hodge, Physiotherapist, NHS Lothian
You can see the blog Jackie also wrote on
What does dementia rehabilitation mean to us as Allied Health Professionals? Part 1- physical health and keeping active by Jackie, a physiotherapist
here . Enjoy
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