Short answer: The weeks after leaving hospital are a high-risk window for many older adults. Australian community falls guidelines note higher risk of falls and serious injury in the first month after discharge, when people are often still recovering from illness and deconditioning. In-home physiotherapy and exercise physiology can rebuild strength, balance and confidence in the rooms and routines that matter. Alera Healthcare provides mobile Physio and Exercise Physiology across Sydney Metro as an associated Support at Home provider, with the same clinician where possible.
Why the first month after hospital matters
Hospital care treats the acute problem. Home life asks for something else: getting out of the favourite chair, managing the bathroom step, walking to the kitchen when energy is low, and sleeping in a familiar bed that suddenly feels less steady.
The Australian Commission on Safety and Quality in Health Care’s 2025 Falls Guidelines for Community Care state that older people have a higher risk of falls and falls with serious injury in the first month after being discharged from hospital. The guidelines link that risk to recent acute illness and deconditioning from the hospital stay. Best practice, they say, supports coordination and continuity between the hospital, the older person, carers and family, the GP, health professionals, and home and community services.
That is not a scare line. It is a planning cue for Sydney families and discharge teams: the discharge summary is the start of the home chapter, not the end of care.
What the numbers say about falls at home
Falls remain the leading cause of injury hospitalisations in Australia. According to the Australian Institute of Health and Welfare (AIHW), updated June 2026:
- In 2024–25 there were 253,800 fall-related hospitalisations (43.4% of all injury hospitalisations; 926.1 per 100,000 population).
- People aged 65 and over were hospitalised for falls about 12 times more often than adults aged 25 to 44 (3,275.3 versus 268.1 per 100,000).
- Among people aged 65+, the most commonly specified place of occurrence for fall hospitalisations was the home (1,766.4 per 100,000 in that age group).
- Fractures were the most common injury type in fall hospitalisations (53.3%).
AIHW also estimates fall-related injuries cost the health system about $5.4 billion in 2023–24. Many serious events start with a slip, trip or stumble on the same level, often indoors. Clinical commentary similarly flags elevated falls after discharge (rates vary by study; some cohorts report about four in ten older adults falling within six months). The practical takeaway is consistent: the transition home deserves a plan, not hope alone.
What “deconditioning” means in plain English
Deconditioning is the loss of strength, stamina and balance that can build up when someone has been unwell, in bed more than usual, or moving less than their normal week. It can show up as:
- Needing more arms and a rock forward to stand from a chair
- Shorter walking distance before fatigue
- Feeling unsteady turning in a hallway or bathroom
- Avoiding stairs, the front path or outdoor steps
- Fear that quietly shrinks daily life
None of these prove a future fall on their own. Together they are a reason to arrange a clinical review early, especially in that first month home.
How physiotherapy and exercise physiology help after discharge
At Alera Healthcare we provide physiotherapy and exercise physiology at home. We do not offer occupational therapy.
- Physiotherapy assesses gait, balance, transfers, pain and mobility after illness or surgery, then builds a programme that matches the person’s real home layout and routines.
- Exercise physiology designs progressive exercise for capacity, chronic conditions and healthy ageing, with clear safety parameters and measurable steps.
Many people benefit from both across a recovery journey. If another kind of care is the better fit (for example an occupational therapist for a full home-safety assessment when guidelines recommend one), we say so early.
The 2025 community falls guidelines recommend that all older people aim for about 2 to 3 hours of ongoing weekly exercise that primarily targets balance and mobility and includes strength training, designed and delivered by physiotherapists, exercise physiologists or appropriately trained instructors (Level 1A). For people at increased falls risk (one or more falls in a year), programmes should be tailored, and supervision may be required so exercise stays both challenging and safe.
In the post-discharge window that often means a clear home baseline, practice in real rooms (chair, bathroom threshold, hallway turns), progressive strength and balance as energy returns, carer coaching between visits, and clear updates to the care coordinator when risk or goals change.
Why in-home care fits the discharge month
Clinic floors are even and well lit. Real Sydney homes are not. An in-home clinician can watch the actual chair height, the wet bathroom floor pattern, the front step and the evening lighting that families live with every day.
Continuity matters in this window. Wherever possible, the same physio returns, so the person is not retelling their story each visit, and carers know who is coming. We have worked with Sydney families in this mobile model since 2004.
We are an associated Support at Home provider, working alongside registered providers, and we are not a registered 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. We do not offer occupational therapy or NDIS services.
Practical checklist for the first fortnight home
Use this as a starting point (not clinical advice):
- Confirm who owns mobility follow-up on the day of discharge
- Note near-misses, furniture-cruising and activities quietly dropped
- Prioritise strength and balance, not only “a bit of walking”
- Recheck footwear, night lighting and cluttered walkways
- Book a clinician review if walking feels less steady than before hospital, or if fear is shrinking daily life
- Clarify Support at Home or private funding before care starts
Frequently asked questions
Is the first month after hospital really higher risk?
Yes. The ACSQHC 2025 community falls guidelines state that older people have a higher risk of falls and falls with serious injury in the first month after hospital discharge, linked to recent acute illness and deconditioning. Coordinated follow-through between hospital, GP, family and community clinicians is recommended.
Do we need physiotherapy, exercise physiology, or both?
It depends on goals and presentation. Physiotherapy often leads when gait, pain, transfers or post-surgical mobility need assessment. Exercise physiology often leads when progressive capacity, chronic disease exercise and longer-term conditioning are the main need. Many recovery plans use both over time. Alera Healthcare can help map suitability on a short call.
Can this be funded under Support at Home?
Clinical supports such as physiotherapy may be available under Support at Home arrangements for eligible people, working with a registered provider. Alera Healthcare is an associated provider. We do not hold the participant’s Support at Home funding ourselves. Exact entitlements depend on the person’s plan and authorisations, which we discuss case by case.
Is Alera’s 15-minute call a free treatment session?
No. We offer a 15-minute call to understand needs, check Sydney Metro coverage, and explain next steps. It is not a free clinical treatment consultation.
Soft next steps
If someone you support is coming home from hospital, or is already home and less steady than before admission, book a 15-minute call. Care coordinators and discharge planners can use the referral pathway or explore services, including physiotherapy and exercise physiology. Funding questions are covered on funding. We work across Sydney Metro; see locations.
Call 040 55 77 555 or email reena@alerahealthcare.com.au.
The first month home is when small, practised steps in the right rooms often matter most. Steady, evidence-informed Physio and EP at home is how Alera Healthcare supports that transition for Sydney families.
Sources
- 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 Institute of Health and Welfare, Injury in Australia: Falls (updated 18 June 2026), https://www.aihw.gov.au/reports/injury/falls
- AIHW health system spending on disease and injury (falls expenditure, 2023–24)
- Australian Physiotherapy Association materials on community falls prevention and reablement
- Clinical commentary on post-discharge falls risk in older adults (rates vary by cohort)