Physiotherapy for Older Adults at Home: Mobility and Falls Prevention
Updated: Sep 5
Changes in walking, strength and balance can happen gradually. Someone may start using the arms of a chair more, avoid stairs, walk shorter distances or feel less confident outside before they describe themselves as having a mobility problem. A home physiotherapy assessment can help identify what is contributing and what can realistically be trained.
When might home physiotherapy help an older adult?
Walking has become slower or less confident
Getting out of chairs or climbing stairs is harder
Strength has reduced after illness or a hospital stay
A walking stick or frame is being used and needs review
There has been a fall, near-fall or growing fear of falling
A long-term neurological or musculoskeletal condition is affecting movement
What does the assessment look at?
The assessment is chosen around the person's difficulties and goals. It may include walking, turning, balance, leg strength, sit-to-stand, stairs, transfers and use of mobility aids. The home environment can also provide useful context because the physiotherapist can see the actual chair, staircase and spaces the person manages every day.
Falls need more than a simple balance score
A fall can have several contributing factors. Current NICE guidance recommends comprehensive falls assessment and management for people who have fallen in the last year and meet criteria such as repeated falls, a fall requiring medical treatment, frailty, loss of consciousness related to a fall or being unable to get up independently afterwards. A comprehensive assessment can consider gait, balance, mobility, muscle strength, medication, vision, continence, neurological factors and other relevant health conditions.
For someone who has fallen once and has a gait or balance impairment, NICE recommends a falls-prevention exercise programme and consideration of a home hazard assessment.
What can physiotherapy work on?
Where reduced strength, balance or physical capacity is part of the problem, rehabilitation may include progressive leg strengthening, stepping and turning tasks, balance exercises, walking practice, stair work and repeated functional tasks such as sit-to-stand. NICE says falls-prevention exercise should be progressive, tailored to the person's needs and goals, and focus on functional components such as balance, coordination, strength and power.
Is a group strength and balance class suitable?
For someone who is medically stable, can mobilise independently or with their usual aid and wants structured exercise rather than an individual assessment, a supervised group can be a useful way to practise strength and balance consistently. The Joydens Wood Strength & Balance Group is led by HCPC-registered physiotherapist Tom Morgan and exercises can be adapted to different starting abilities.
The group runs on Thursdays from 6:00 pm to 7:00 pm at St Barnabas Church, Joydens Wood, costs £12 per session, has free parking and a wheelchair-accessible venue.
When is an individual home assessment the better starting point?
An individual assessment is more appropriate when mobility has changed significantly, there are repeated or unexplained falls, the person is struggling with transfers or stairs, there is uncertainty about safe exercise, a neurological condition is affecting movement, or a personalised rehabilitation plan is needed before joining a group.
Tom Morgan Physio Solutions offers 60-minute mobile physiotherapy assessments across Kidbrooke, Blackheath, Greenwich, Eltham, Charlton, Woolwich, Lewisham and surrounding parts of South East London for £85.
View current home physiotherapy assessment availability.
When should medical help come first?
Sudden new weakness, facial droop, speech difficulty, loss of consciousness, severe dizziness, a significant injury after a fall or another acute change needs appropriate medical assessment rather than waiting for routine physiotherapy. Repeated or unexplained falls may also need wider multidisciplinary assessment rather than being treated as an exercise problem alone.
For more physiotherapist-led strength, balance and falls-prevention information, see theStrength & Balance Physiotherapy Resource Hub.
For assessment and treatment options,view all mobile physiotherapy services.
Home Physiotherapy for Older Adults in Greenwich and South East London
If you need advice tailored to you, book a physiotherapy assessment.
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