Physiotherapy for Older People at Home
You've found the right people.
We are chartered physiotherapists who specialise in older people, and we come to you. Most of our work is with people in their eighties and nineties — after a fall, an operation, an illness, or a slow decline that’s been going on longer than anyone quite noticed.
No referral, no waiting list, and usually at the door within a few days of a hospital discharge.
Most people find us because someone in the family noticed first. That she’s stopped going upstairs. That she’s holding the furniture. That she hasn’t been out since the fall — not because of the injury, but because she’s frightened of another one. Often the hospital has discharged her, the six weeks of NHS support have ended, and everyone has moved on except the person watching it happen.
You don’t need to wait for a crisis, and you don’t need permission.
Not sure whether we can help? Speak to Michelle or Christina — our coordinators are community physiotherapists, not call handlers. Tell us what’s actually happening and we’ll give you an honest answer, including if the answer is that we
can’t.
0800 772 0542 · Or send us a message
Conditions we commonly see
Most people we visit have several of these at once. That combination is usually the point — it’s what makes managing at home hard.
- After a fall or fracture — get moving and rebuild confidence
- After surgery — hip and knee replacements, recover quickly once home
- Frailty and deconditioning — after a hospital stay or illness, get going again
- Arthritis and long-term pain — hips, knees, backs and shoulders
- Osteoporosis — where the priority is preventing the next fracture
- Dementia — Alzheimer's, vascular, Lewy body and mixed presentations
- Parkinson's, stroke and MS — walking, turning, staying steady
- Heart failure and COPD — build stamina, breathe easier
- Reduced mobility with no single diagnosis — we assess and set a plan
If none of these quite describes it, it’s still worth a conversation. Sometimes there’s no single diagnosis and plenty that can be improved.
If your relative lives in a care home, see our care home physiotherapy page.
Working with the GP, the hospital and the carers
Nobody gets older on their own, and we are rarely the only people involved. There may be a GP, a hospital team who has just discharged her, a falls service, a reablement team for the first few weeks home, an occupational therapist who has fitted rails and a raised toilet seat, and carers who come in every day. We fit in with all of them.
With her permission, we read the discharge letter and anything else already written, follow any precautions in place, and let the GP know what we are doing. If we see something that needs a doctor, such as pain that is not controlled, dizziness when she stands, or a medicine that seems to be affecting her balance, we say so and write to the surgery rather than working around it. And when the reablement team’s weeks come to an end, we can pick up where they left off, so the progress does not stop just because the free support has.
Why people go backwards, and what to do after a fall
Strength is lost far faster than it comes back, and in older age the gap is widest. A week in bed, a chest infection, or a fall that leaves someone afraid to move can take away months of ability, and the less someone does, the harder the next thing becomes. Our article on why two weeks in hospital can undo a year of walking explains how quickly it happens.
The good news is that the right exercise works. A Cochrane review of 108 trials found that exercise programmes reduce the rate of falls in older people living at home by around a quarter, and that programmes combining balance and strength work probably cut falls by about a third (Sherrington et al., Cochrane, 2019). That is why we spend so much time on standing, turning, stepping and strength, and why the programme has to be done, not just handed over.
If she falls
Call 999 if she may have hurt her head, back, neck or hip, or cannot get up.
Call NHS 111 if she may be in pain, injured or unwell but none of the above applies.
See the GP after any fall, even if nothing seems broken. A fall is often the first sign of something else.
If she cannot get up, do not try to lift her on your own. Keep her warm with a blanket, help her change position every half hour or so, and wait for help. If she can get up, the NHS advice is to roll onto her side, get onto hands and knees, and use a sturdy chair to come up slowly. We teach this at home, on her own floor, before she ever needs it. Based on NHS guidance on falls.
If you've been told there's no rehabilitation potential
It’s one of the most common things families tell us, usually with some resignation. That she’s too old. That there’s no rehab potential. That nothing more can be done.
Sometimes that’s an honest clinical judgement. Often it means someone won’t return to exactly how they were — which may well be true, and isn’t the same thing at all.
Muscle responds to training at any age. The capacity to build strength doesn’t appear to be lost in very old age, and there is good evidence of measurable gains in people in their eighties and nineties. What changes is how a programme has to be designed and supported, not whether it works.
We’ll assess and tell you honestly what we think is achievable — including, sometimes, that it’s very little.
If she won't engage, that's what we're good at
Families often tell us this part with some embarrassment. That their mother won’t do the exercises. That she’s given up. That she was short with the last physiotherapist and hasn’t been the same since. That it’s hard to watch someone who was capable and independent become someone who needs help to stand up.
None of that is unusual, and none of it means we can’t help. It’s most of what we do.
Low mood is common in older people and often missed. Memory and planning change with age, so someone can want to do their exercises, understand why they matter, and still not be able to organise themselves into starting. Apathy looks exactly like refusal, and is usually neither stubbornness nor giving up.
We know how to work with that, and mostly it means designing around it rather than pushing through it. Fewer exercises, in the same order, every day. One instruction at a time, never two. Attached to something that already happens — after breakfast, before the news — rather than added to the day as a new event. Cues left where the activity happens, not on a sheet in a drawer. And someone else carrying the remembering, which is usually the family or the carer, and is the single biggest predictor of whether a programme continues.
We explain what we’re doing and why — to your mother, not over her head. Where low mood looks like part of the picture, we’ll say so and suggest you raise it with her GP.
We’ll also be straight with you about what we’re seeing. Being gentle and being honest aren’t in conflict.
Exercises designed for your home, that actually get done
Look at any physiotherapy exercise app. The demonstrator is thirty, on a mat, on the floor, in leggings. To someone of eighty-five, that picture says one thing: this is not for me. And they’re right — it isn’t.
Most home exercise programmes are handed over and never done. When that happens the patient gets the blame: not motivated, not compliant. We think the programme is usually at fault. It was written for someone else, in someone else’s house, at a level nobody came back to check.
So we built our own. Real rooms, real chairs, real people the age of the people we treat. Four decisions went into it, and every picture below is taken from it.
Filmed Where You'll Do Them
This is heel raises. Not in a gym — at a kitchen worktop, hands hovering over the surface, kettle on. Every exercise on our programmes is shown in the room it will actually be done in: the armchair, the edge of the bed, the bottom stair. Nobody is asked to get down onto the floor. If the person on screen is somewhere that looks like your house, the exercise looks like something you could do.
On Screen Or On Paper
Sit. Lean forward. Stand. Three pictures, no words needed — which is the point. A programme that only makes sense on a phone is a programme that gets abandoned when the phone is in the other room. Ours works on a tablet, on a phone, or printed large and left on the arm of the chair. Whatever gets it done is the right format.
It Changes As You Do
A cushion squeezed between the knees is where a lot of programmes start. It isn’t where they finish. Your physiotherapist updates the plan between visits — harder as you get stronger, exercises retired when they’ve done their job, new ones added when the next thing becomes possible. It’s a live plan, not a leaflet handed over once.
Made For You If Nothing Fits
Most libraries stop where the standard exercises stop. Ours doesn’t. If someone has an amputation, a stroke that affects one side, or a body that simply doesn’t do what the diagram shows, your physiotherapist films or builds the exercise for that person — this bridging exercise for a man with an above-knee amputation is one of them. The programme fits the patient, not the other way round.
Why we train everyone else too
Teaching The Purpose
Every exercise on the programme has a reason behind it, and we make sure the people around you know what it is. A carer who understands that a sit-to-stand is building the strength to get off a toilet unaided will protect that exercise. One who thinks it’s just a stretch won’t.
How Much Help
We spend three sessions teaching someone to stand from their armchair under their own power — leaning forward far enough to get their weight over their feet, which is frightening at first and takes real practice. Then a carer takes both hands and lifts them. Kindly, quickly, with the best intentions. That undoes the work.
When To Step Back
Nobody did anything wrong in that example; nobody had explained why it mattered. So we show carers and family exactly where to stand, what to say, and when to wait — including the uncomfortable pause while someone works out how to do it themselves. That’s how the other fifty contacts start pulling in the same direction.
Short, Functional and Fun.
Three rules govern every programme we write.
Short. Four exercises done every day beats twelve done twice. Long programmes get abandoned, and an abandoned programme achieves nothing.
Functional. We practise the things that actually matter — standing up from the chair you sit in, managing your own stairs, getting to your own bathroom at night. Not abstract movements that have to be translated into real life later.
Fun. Or at least tolerable, and preferably social. Rehabilitation that feels like a chore stops. Rehabilitation built into something you already do, with someone you like, continues.
What a visit looks like
Before the first visit we send a short pre-assessment form, so her history, her medicines and any recent hospital stays are known before anyone knocks on the door. The visit itself takes around an hour, and it is an assessment that includes treatment, never an hour of talking. Most of it is spent watching: how she gets out of her own chair, how she manages her own stairs, how far she walks and what stops her. We measure it, agree what we are aiming for, and tell you honestly what we think is achievable.
After that, the visits follow the plan. A typical session is practice on the things that matter in her house, such as the chair, the stairs, the bathroom and the front step, plus a short, filmed programme for the days in between, and time with whoever else helps her so they are pulling in the same direction. Most people need a concentrated run of visits and then far less. We will say plainly when it is time to space them out or stop.
What families tell us
Who will visit
The people below are the chartered physiotherapists and physiotherapy assistants who visit older people at home and in care homes across the areas we cover. Most of our physiotherapists have spent years in NHS community and older people’s services before joining us, so they have usually seen the situation you are in many times before. The physiotherapy assistants help with the regular practice between visits, under the physiotherapist’s plan. Every Caring Physio physiotherapist is HCPC registered and a member of the Chartered Society of Physiotherapy.
Paying for physiotherapy
Most people pay for their own visits, or their family does. We charge by the hour, with mileage for the physiotherapist’s travel, and every figure is published on our pricing page, so nothing comes as a surprise.
Private health insurance can help, especially after a fall, a fracture or an operation. Aviva and WPA both accept our home visits; as one husband put it, we “made sure that Jill was registered with them so that I could make a claim”. Check your policy covers physiotherapy at home, and ask for an authorisation code before the first visit.
If she is over State Pension age and needs help with personal care, it is worth checking whether she can claim Attendance Allowance, which can go towards the extra costs of getting older at home.
Where we visit
We visit people at home, in sheltered housing and in care homes across twenty counties in England, with no GP referral needed. That includes Leamington Spa, Windsor, Oxford, Aylesbury, Basingstoke, Kensington, Bath and Morpeth. To see who covers your own town, find it on our areas page, and if it isn’t listed, ring anyway.
Physiotherapy for older people: your questions
My mother has been told she has no rehabilitation potential. Is it worth us asking again?
It is worth looking, and we will tell you honestly what we find. A judgement like that is made about how things stood on a particular day, usually by somebody who was right about that day. Circumstances change. The commonest reason a goal gets missed is time — not enough of it to build the strength and the confidence that sit underneath the goal. The longer somebody has not done something, the bigger it looks, and that is normal rather than evidence. We would start by working out what is actually stopping her.
She will not do her exercises. What happens then?
That is the job, not an obstacle to it. Almost nobody does a sheet of exercises left on the table, and we do not expect them to. We do them with you, we build them into things that already happen in the day — standing up from the chair, walking to the kitchen, getting up from the toilet — and we show whoever else is around what helps. If somebody genuinely does not want to, we will say so rather than keep visiting, but that is far rarer than families expect.
Is he too old, or too frail, for physiotherapy?
Age on its own is almost never the reason something is not possible. Frailty is a reason to work differently, not a reason not to work — shorter sessions, lighter loads, more repetition, more rest. Some of the biggest changes we see are in people in their nineties, because they had the furthest to come back. What we will not do is promise an outcome. We will assess, tell you what we think is achievable, and be honest either way.
Is it worth having physiotherapy after a fall, even if nothing was broken?
Yes, and it is one of the best times to start. A fall with no injury is often the first sign that strength or balance is slipping, and the fear it leaves behind can do more harm than the fall itself: people start holding the furniture, stop going out and move less, which makes the next fall more likely. We look at why it happened, whether that’s weak legs, a dizzy turn, a rug or poor lighting, work on the strength and balance underneath it, and practise getting up from the floor so it is less frightening if it happens again. It is also worth telling her GP, because a fall can be the first sign of something else.
She is frightened of falling again. Can you help with that?
Yes, and fear is often a bigger problem than the physical damage. Someone who is afraid of falling stops doing the things that keep them strong, and the fear becomes self-fulfilling. We deal with it the same way you would get over any fear: small steps, practised with someone beside you until they feel ordinary. That might be standing at the kitchen worktop with nobody holding on, then walking to the front door, then the end of the path. We also teach her how to get up from the floor, because knowing she could manage makes a fall far less frightening to think about.
How quickly can somebody actually improve?
Most people notice something within two or three visits — usually confidence before strength. Meaningful change in how far somebody walks, or whether they can get off a low chair unaided, typically takes six to eight weeks of consistent work. We measure at the first visit precisely so that progress is a fact rather than an impression, and so we can tell you plainly if it is not happening.
She has carers coming in and she is still going backwards. Why?
Because care and rehabilitation are different things, and most people only have the first. A care package is built to make sure the day happens safely; it is not built to make anybody stronger, and it would be unreasonable to expect it to be. Meanwhile the activity that used to maintain her strength — standing, walking to the kitchen, dressing slowly — has been absorbed into someone else’s visit. Neither of those is anyone’s fault. What changes it is deciding which parts of the day she should keep doing herself, and working at them deliberately until they are hers again. We have written more about this in a care plan written on the day you came home does not have to be forever.
Can you work with somebody who has dementia?
Yes, and it changes how the work is done rather than whether it is worth doing. Shorter sessions, the same order every time, instruction by demonstration rather than explanation, and practising real things in real places rather than abstract exercises. Strength and balance protect independence and reduce falls whatever else is going on, and a fall is one of the quickest ways to lose the ground somebody has left.
How long would this go on for? I do not want an open-ended commitment.
Nor do we. Most people need a concentrated run of visits and then far less — a review every few weeks, or nothing at all. We stay while the work is making a difference and say so plainly when it stops. If we do not think we are adding anything, we will tell you rather than keep coming.
I live a long way away. How would I know it is working?
You would hear from us directly, without having to chase anybody. It is a common position, and often the reason families ring in the first place — the person who worries most is frequently the one who cannot see for themselves. We measure at the start so progress is a fact rather than an impression, we report after visits by phone, email or WhatsApp, whichever suits you, and you can contact us yourself rather than going through whoever is nearest. If something is going backwards, you will hear it from us first. Our fees are published in full on the pricing page.
Still have a question?
Every older person’s situation is a mix of things, and the answer you need may not be above. Ring and speak to one of our physiotherapists before you decide anything. If we are not the right people to help, we will tell you, and tell you who is.
It helps to have these to hand when you call
- Any recent falls or hospital stays, and roughly when
- Her current medicines, or the list from the GP
- What she can and cannot do at the moment: stairs, bathroom, getting out
- What help is already coming in: carers, family, equipment
- Your insurer and authorisation code, if you are claiming
Every Caring Physio physiotherapist is
- HCPC registered and a member of the Chartered Society of Physiotherapy
- DBS checked and fully insured
- Used to working alongside GPs, falls services and carers