Physiotherapy in nursing homes.

Relevant information may include recent illness, surgery, changes in mobility, pain, fatigue and existing medical or rehabilitation instructions. The physiotherapist and the home’s clinical lead should agree what needs to be available, who can share it and whether further advice is required before a visit.

A resident’s diagnosis alone does not establish suitability. The assessment considers current presentation, priorities, tolerance and risks. Where needs fall outside the available physiotherapist’s competence or require a different specialist service, that should be explained rather than a generic programme being offered.

Goals may relate to getting out of bed, sitting comfortably, participating in transfers, maintaining movement or returning to a familiar activity. For some residents, rehabilitation aims to regain function; for others, maintaining ability or improving comfort may be more appropriate. Goals should be agreed with the resident wherever possible and revisited as circumstances change.

Positioning, seating or equipment concerns may require joint working with nursing staff, an occupational therapist or a specialist service. Recommendations about moving and handling must be coordinated with the home’s assessment and equipment procedures. Physiotherapy does not replace those responsibilities.

Appointment timing should consider meals, personal care, medication routines, rest and other treatment. The team should know how much assistance is needed during a session and whether particular staff should be available. Clear preparation can prevent an appointment becoming tiring or impractical for the resident.

With the necessary consent or authority, the physiotherapist can communicate agreed findings and recommendations to the nursing team. Changes such as a marked reduction in tolerance, new pain or deterioration should be escalated through the resident’s clinical plan rather than waiting for the next therapy appointment.

• Agree the clinical contact and access to relevant records
• Clarify assistance, equipment and space required for the visit
• Document responsibilities for support between sessions
• Review goals alongside changes in nursing or medical needs

A nursing home can enquire about a resident assessment or a proposed visiting arrangement. Families can also contact us, with the home involved in practical and clinical planning. We need the postcode, broad needs and a named contact before considering clinician availability.

The written proposal should distinguish assessment, follow-up treatment, reporting and any agreed coordination time. Funding and consent should be established for each resident. Ongoing nursing care, physiotherapy and any specialist equipment remain distinct elements unless expressly included in the agreed arrangement.