Build confidence in balance and everyday movement.

Assessment begins with what happened, what has changed and which activities now feel difficult. The physiotherapist considers mobility and relevant physical factors while recognising that medication, vision, illness and the environment may need assessment by other professionals. Physiotherapy alone is not a complete falls assessment for every person.

If a fall involves injury, a possible blackout or a sudden unexplained change, appropriate medical assessment takes priority. A routine rehabilitation appointment is not a rapid-response service and should not delay urgent help.

Following assessment, an individual programme may focus on strength, balance, walking or practising relevant activities. It should explain the level of support needed and how activities can be adapted. A programme for someone in a nursing home will need to reflect different resources and risks from one practised independently at home.

Confidence deserves attention too. A practical goal may be returning to a familiar room or an activity the person has started avoiding. Progress should be reviewed against meaningful activities and the person’s experience, without promising that exercise will prevent every fall.

• Discuss usual walking aids and the assistance currently needed
• Identify everyday movements that feel unsafe or have become restricted
• Agree safe supervision and support for the selected activities
• Review changes in confidence, function and tolerance

Advice about hazards or equipment may need coordination with the responsible care team, an occupational therapist or a falls service. Existing moving-and-handling instructions should remain in place unless formally reviewed. Do not change a walking aid or transfer technique simply because it appears in a photograph or general guide.

In a care home, staff observations about changes in mobility can help inform review. At home, relatives may notice increasing fatigue or avoided activities. Agree a way to share relevant changes and clarify when the person needs medical advice rather than an adjustment to exercise.

An initial enquiry can explain the setting, postcode, broad mobility concern and whether falls have already been assessed by a clinician. We will discuss whether physiotherapy is an appropriate next step and confirm available expertise before booking.

Ask for assessment and follow-up fees, what guidance is included and when a review is proposed. There is no standard course length or guaranteed reduction in falls. The plan should remain proportionate to the individual’s needs, wishes and response.