Whether it is you or a parent who has become unsteady, nervous on the stairs or slower after a spell in hospital, a physiotherapist can help. We come to the home, test balance and strength, and build a programme that fits the person, the house and the day.
The short answer
A physiotherapist tests balance, leg strength and walking, then sets a progressive programme of strength and balance exercises and checks the home for hazards. Research shows exercise reduces the rate of falls in older people, and doing it at home means the practice happens where the person actually lives.
None of these means something is seriously wrong. Together they are a good reason to have balance and strength looked at before a fall makes the decision for you.
If a fall has caused a head injury or severe pain, or you suspect a broken bone, get medical help first. Physiotherapy comes after.
At the first visit we walk through the home with the person, looking at how they really move. These are the six places we check most, and what usually helps.
What we look for
Loose mats, poor lighting, a step at the threshold, and how the person manages the door and keys.
What usually helps
Fixing or removing mats, brighter bulbs and night lights, a sturdy rail where there is a step, and practising stepping up and down the threshold.
What we look for
A handrail on each side, lighting, worn carpet, and whether the person uses the rail, rests on the way or leans on the wall.
What usually helps
Rails where they are missing, a clear way of climbing (one step at a time if needed), and leg strengthening so the stairs feel less of an effort.
What we look for
Low or deep chairs, cluttered walkways, trailing cables, and how the person stands up and sits down.
What usually helps
A seat that suits the person’s height, clear walking routes, and practice at standing up without pushing on the arms.
What we look for
Wet floors, getting in and out of the bath or shower, the height of the toilet, and where the person grabs for support.
What usually helps
Non-slip mats, advice on rails, a raised toilet seat or a shower seat, and signposting to occupational therapy for fitted equipment.
What we look for
Getting in and out of bed, night-time trips to the bathroom, lighting, and what is on the floor.
What usually helps
A light within reach, a clear path to the bathroom, and a routine of sitting on the edge of the bed for a moment before standing.
What we look for
Reaching high shelves, standing for long periods, and carrying hot drinks or plates.
What usually helps
Moving everyday items to waist height, sitting down for food preparation, and practising reaching and bending safely.
After a fall, or even a near miss, many people start doing less. They stop going out, avoid the stairs and sit for longer. It feels sensible, but muscles weaken and balance gets worse quickly, which makes a real fall more likely.
Confidence is part of the treatment. We start with movements the person can do safely, add challenge in small steps, and let them see their own progress. Having a physiotherapist beside you while you practise is very different from being told to be careful.
At home we can practise the things that worry people most: stepping into the bath, carrying a cup of tea across the kitchen, or getting up from a low chair.
Doing less feels safer, but it makes falls more likely. The answer is to get stronger, not to be more careful.
Six things we do, in plain terms.
Simple, recognised tests of balance, leg strength and walking speed give us a starting point and let us show progress.
Exercises set at the right level and made harder as the person improves, practised standing where it is safe to do so, because balance is trained by challenging balance.
Checking that a stick or frame is the right height and used well, and that shoes and slippers help rather than hinder.
Rebuilding strength and stamina after a hospital stay, an infection or a fall, at a pace that suits the person.
The room-by-room check above, with a short written list of practical changes.
A simple programme with clear pictures, and guidance for family on helping without taking over.
It can be hard to raise the subject. These are the four steps most families find work.
Talk about the things they enjoy and want to keep, such as the garden, the walk to the shop or visiting the grandchildren, rather than about falls or frailty.
You can arrange it for them. The first visit lasts an hour, and you are welcome to be there if they would like that.
We speak to the person first and the family second. They hear what we found, what we suggest and why, in plain language, and decide with us.
With the person’s permission, we can update you after visits and tell you what to look out for between sessions.
Not sure where to start? Call or message us before you book, and we will explain what would happen at the first visit.
We stick to claims we can link to, so you can check them.
Exercise reduces the rate of falls in older people living in the community by 23% (rate ratio 0.77, 95% CI 0.71 to 0.83; 59 studies, 12,981 participants; high-certainty evidence). The effect was larger where a health professional, usually a physiotherapist, delivered the programme.
Sherrington et al., Cochrane review: exercise for preventing falls in older people living in the community (2019) (opens in a new tab) ↗NICE’s falls guideline covers people aged 65 and over, and people aged 50 to 64 at higher risk. It recommends that people living in the community who have fallen have their gait and balance assessed, and are offered a falls prevention exercise programme when an impairment is found.
NICE guideline NG249: falls, assessment and prevention in older people and in people 50 and over at higher risk (2025) (opens in a new tab) ↗UK Chief Medical Officers’ guidelines advise adults aged 65 and over to do activities that improve strength, balance and flexibility on at least two days a week.
UK Chief Medical Officers’ physical activity guidelines (2019) (opens in a new tab) ↗
Senior Chartered Physiotherapist · HCPC PH108630
Payal holds a Bachelor of Physiotherapy and a Level 3 leadership qualification from the University of Birmingham. She leads Rehalign’s home visits for older adults.
Every Rehalign physiotherapist is HCPC-registered. Meet the team.
Travel is included in every price, with no mileage surcharge, and bundles are there if a longer programme would help.
£76/session • Save £20
£72/session • Save £80
Short, practical reading for older adults and the families who support them.
Falls are a leading cause of injury in older adults. Learn how targeted balance training and home safety assessments by Rehalign preserve independence.
A room-by-room guide to spotting fall risks in an elderly relative's home, plus the personal warning signs to watch for and when to get a professional assessment.
Fear of falling again affects up to half of older adults after a fall. Why it happens, the vicious cycle it creates, and what actually helps rebuild confidence.
Balance declines with age due to changes in proprioception, muscle strength and reaction time — but physiotherapy can measurably restore it. Here's how.
Yes — research shows strength training in your 80s (even 90s) can meaningfully improve strength, gait speed and mobility. What the evidence shows and how to start safely.
A practical guide for adult children weighing up home physiotherapy for a parent — how to start the conversation, what to ask a provider, and how cost and insurance work.
We visit people at home in all of these towns, and in the postcodes around them.
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Book a first visit for yourself or a relative. We come to you, explain every step, and never ask anyone to travel.