Short answer: When older adults sit more and practise balance less, strength and confidence often fade together. That mix raises the chance of a fall at home. Australian guidelines put ongoing, tailored strength and balance exercise at the centre of community falls prevention, ideally designed with a physiotherapist or exercise physiologist. Alera Healthcare delivers that care in Sydney homes as an associated Support at Home provider, with the same clinician where possible.
Why this matters for Sydney families
Falls are not a rare mishap of old age. According to the Australian Institute of Health and Welfare (AIHW), falls are the leading cause of injury hospitalisations in Australia. In 2022–23 the AIHW reported 238,055 fall-related injury hospitalisations, about 43.4% of all injury hospitalisations. People aged 65 and over were almost 12 times more likely to be hospitalised for a fall injury than adults aged 25 to 44 (crude rates of 3,217.6 versus 277.5 per 100,000).
Most of those events do not start on a cliff edge. AIHW data on older adults point to slips, trips and stumbles, often on the same level, as a major specified pattern. For a family in Parramatta, the Inner West or the Shire, that usually means the hallway rug, a dim bathroom, wet tiles after a shower, or a rushed transfer from a favourite chair.
Fear of falling can then shrink daily life. Someone who once walked to the letterbox starts staying inside. Less practice means less reserve. Clinicians call that spiral deconditioning: reduced muscle strength, slower reaction time and poorer balance feeding each other.
What deconditioning looks like at home
You do not need a specialist label to notice early signs. Families often see:
- Rising from a chair needing two hands and a rock forward
- Shorter walks and more rests on furniture
- Avoiding stairs, outdoor steps or uneven paths
- Holding walls or furniture for reassurance
- Saying “I am fine” while quietly cutting activities that feel risky
None of these prove a future fall on their own. Together they are a prompt to ask for a clinical review rather than wait for an emergency department visit.
What the Australian evidence says about exercise
The Australian Commission on Safety and Quality in Health Care’s 2025 best practice guidelines for community care put exercise front and centre. For community-dwelling older people, the guidelines recommend supporting ongoing exercise of about 2 to 3 hours per week, primarily targeting balance and mobility and including strength training. They advise that physiotherapists, exercise physiologists or appropriately trained instructors design and deliver those programmes (Level 1A recommendation in the community care guideline).
That dose is not a gym slogan. It is a clinical target: enough challenge, repeated often enough, to change how someone stands, steps and recovers when balance is disturbed.
The Australian Physiotherapy Association has highlighted the same message when welcoming the national falls guidelines: tailored, ongoing exercise led by trained clinicians is a core prevention tool across community, residential and hospital settings. APA commentary also points to research summarised by Sherrington and colleagues (2019) showing that exercise programmes focused on balance and functional training can reduce the number of falls by almost 25% among community-dwelling people aged 60 and over. Individual results vary. Programmes need progression, safety checks and enough weeks of practice to matter.
Exercise & Sports Science Australia (ESSA) position material on falls prevention likewise stresses progressive, balance-challenging exercise and lower-limb strength, tailored to the person rather than a one-size class.
Physiotherapy and exercise physiology: who does what
At Alera Healthcare we keep the scope clear:
- Physiotherapy assesses mobility, gait, balance, pain and recovery after illness or surgery, then builds a home programme that matches the rooms and routines the person actually uses.
- Exercise physiology designs progressive exercise for capacity, chronic conditions and healthy ageing, with clear safety parameters and measurable steps.
Many seniors benefit from both across a care journey. We do not offer occupational therapy or NDIS services. If another kind of care would suit you better, we say so early.
Why in-home care fits falls prevention
Clinic corridors are smooth and well lit. Real homes are not. An in-home clinician can watch how someone:
- Stands from their own lounge
- Turns in a narrow hallway
- Steps into a shower recess
- Manages the front path or garage threshold
That context shapes practice that transfers to daily life. Continuity helps too. Wherever possible, the same physio returns, so the person is not retelling their story each visit, and carers know who is coming.
We work across Sydney. We are an associated Support at Home provider. When Support at Home funding applies, a registered provider holds the participant’s funding and plan. We deliver physiotherapy and exercise physiology in coordination with that organisation as authorised. We also see DVA clients where eligible, and private-paying clients and families. Fees are confirmed on enquiry.
Practical steps families can take this week
- Notice the week, not only the fall. Track near-misses, furniture cruising and activities quietly dropped.
- Check the environment once with fresh eyes. Lighting, loose mats, cluttered walkways and footwear matter alongside exercise.
- Ask for strength and balance, not only “a bit of walking”. Walking helps health in many ways. Falls guidelines emphasise balance challenge and strength as well.
- Seek a clinician if risk is rising. One or more falls in a year, unsteady gait, or fear that is shrinking life are sensible reasons to book a review.
- Ask about funding before care starts. Talk through how Support at Home clinical supports work with your registered provider, or what private options look like.
When to call Alera Healthcare
Consider a short conversation if you or someone you support:
- Has had a fall or near-fall at home
- Feels less steady walking indoors or outdoors
- Is returning from hospital and needs follow-through in the house
- Lives in residential aged care and needs Physio or EP input for mobility and balance
- Has a Support at Home plan and a registered provider ready to coordinate allied health
Alera Healthcare offers a 15-minute call to understand what the client needs, map suitability across Sydney, and explain next steps. This is not a free clinical treatment session.
Soft next steps
Families can book a 15-minute call. Care coordinators and discharge planners can use the referral pathway or call 040 55 77 555. Email admin@alerahealthcare.com.au.
Movement that is practised in the places seniors already live is often the most useful kind. Steady, evidence-informed care at home is how Alera Healthcare has worked with Sydney families since 2004.
Sources
- Australian Institute of Health and Welfare, Injury in Australia: Falls (https://www.aihw.gov.au/reports/injury/falls)
- Australian Commission on Safety and Quality in Health Care, Preventing falls and harm from falls in older people: best practice guidelines for Community Care in Australia (2025)
- Australian Physiotherapy Association commentary on national falls guidelines and exercise evidence (https://australian.physio/)
- Sherrington et al. (2019), exercise for preventing falls in older people living in the community (Cochrane-linked evidence summarised in APA clinical commentary)
- Exercise & Sports Science Australia position material on exercise for falls prevention in older people