Geriatric
Rehabilitation

What geriatric physiotherapy addresses

• Falls and balance problems — the single biggest threat to independence in later life
• Loss of strength and mobility, including after illness or a hospital stay
• Recovery after fracture, particularly hip fracture
• Arthritis and joint pain limiting walking and daily activity
• Frailty and deconditioning — often the underlying issue behind several apparent problems
• Confidence after a fall, which limits people as much as physical weakness

Why strength and balance training is the priority

Muscle mass and power decline with age, and decline faster during illness or bed rest. Strength is what gets a person out of a chair, up a step and to the bathroom at night — and it is trainable well into later life. Balance work is equally trainable and is the intervention with the strongest evidence for reducing falls.

Walking alone is not sufficient. It neither loads the muscles enough to build strength nor challenges balance enough to improve it. A programme that does not get progressively harder is a maintenance plan, not a rehabilitation plan.

What assessment involves

1. History, including any falls in the past year, and what has changed recently
2. Strength, balance, walking and the ability to get up from a chair
3. Standard outcome measures so change can be tracked objectively over time
4. A look at footwear, walking aids and, where relevant, the home environment
5. Goals set around what the person actually wants to do

Falls: the things most often missed

Environmental changes alone do not prevent falls. Three factors are frequently overlooked:

• Medication. Several common medicines increase falls risk, especially in combination. Ask the GP for a review.
• Blood pressure dropping on standing, which is treatable.
• Vision, including the effect of varifocals on stairs.

See fall prevention at home and why elderly people fall.

After a hospital stay

Older adults lose strength strikingly fast during a hospital admission, even a short one. Someone discharged "medically fit" is often not functionally back to baseline. Early reconditioning after discharge prevents a slide into long-term dependence.

Frequently asked questions

Is my relative too old for physiotherapy?

No. Strength and balance improve with training at any age. What changes is the starting point and the rate of progress, not the capacity to improve.

Can this be done at home?

Yes, where travel is difficult — see home physiotherapy. Home programmes still need to progress in difficulty to be effective.

What if there is dementia?

Physiotherapy can still help. It is adapted — shorter sessions, simpler instructions, consistent routine and more family involvement.

References

• National Institute for Health and Care Excellence. Falls in older people: assessing risk and prevention (CG161).