Why "no" is rarely the whole answer
Care managers and families often hear "I don't need physio" or "I'm fine, I just take it slowly." Behind that, there is usually a reason worth hearing. Common ones include:
- "It will be gym work." Many people imagine hard, sweaty exercise. Home physio for older adults is usually built around everyday tasks, like getting out of a chair, walking to the letterbox or managing the front steps.
- "I don't want a stranger in my home." Privacy and routine matter, especially for clients who live alone.
- "They will say I can't stay here." Some clients worry a therapist is there to judge whether they should move. That fear can make people hide near-misses.
- "I've tried it before and it didn't help." A past experience in a clinic, or a program that did not fit, can colour the whole idea.
- "I'm too tired, too sore or too old." Pain, low energy or low mood can make any change feel like too much.
Naming the real reason, gently, helps everyone respond to the right concern.
How to start the conversation
Lead with what the client wants to do
Instead of "you need physio," ask about a goal that matters to them. "Would you like to get to the shops on your own again?" or "Would it help to feel steadier in the shower?" A goal gives physio a purpose the client owns.
Keep it about staying home, not leaving it
Be clear that the aim of in-home physio or EP is to help the person keep doing things in their own home, with confidence. If a fall or near-miss is part of the picture, our guide on fear of falling after a near-miss may help frame it.
Offer a small first step
A first visit does not have to commit anyone to a long program. The therapist meets the client at home, listens, looks at what is hard day to day and agrees goals with them. The client can decide what happens next. Families can use how to prepare for a first home physio visit to make that visit feel less formal.
Let the client set the pace and the time
Offer a time that suits their routine, with a family member present if they would like. Alera visits are available any day, including Saturdays, which can make it easier for a family member to be there.
Offer a familiar face
Clients who dislike strangers often settle once they know who is coming. Wherever possible, the same physio returns for each visit, so the client is not retelling their story to someone new. See why the same physio matters.
What not to do
- Do not book a visit without the client's agreement. Consent matters, and a surprise visit can set things back.
- Avoid framing physio as a test the client might fail.
- Do not push hard in one conversation. A short follow-up a week later often works better than a long debate.
If the client still says no, that is their decision. Record it, keep the door open and check in again when something changes, such as after a hospital stay or a new near-miss. For signs that a referral may be worth raising again, see when family carers should refer for home physio.
When the client says yes
Once the client agrees, the referral can be simple. Our home physio referral checklist for care managers covers what to send. It helps to note in the referral that the client was hesitant and what they care about most, so the therapist can start there.
Support at Home, private clients and DVA
When physiotherapy or exercise physiology clinical supports are authorised under Support at Home, Alera Healthcare can deliver those sessions at home as an associated provider working with the registered organisation that holds the plan. Alera is not a registered Support at Home provider, and the client stays with their current provider and their care manager at that registered provider.
Private clients and families can enquire directly, and DVA clients are welcome to ask about eligibility on enquiry. Alera has provided mobile physiotherapy and exercise physiology across Sydney Metro since 2011. We do not offer occupational therapy or NDIS services.
Next step
Talking with a hesitant client or parent and want to check fit first? Book a 15-minute call to talk it through, or use our referrals page when the client is ready.
Call 040 55 77 555 or email admin@alerahealthcare.com.au.
FAQ
What should I do if an older client refuses home physio?
Ask what worries them, then link physio to a goal they care about, such as walking to the shops or feeling steadier in the shower. Offer a small, low-pressure first visit and respect their decision if they still say no.
Is home physio for older adults just exercise?
No. Home physio usually focuses on everyday tasks in the client's own home, like getting up from a chair, walking, managing steps and reducing fall risk. Exercises are chosen to suit the person and their goals.
Can a family member be present at the first home visit?
Yes, if the client would like that. Many families find it helps the client feel comfortable, and Alera visits are available any day, including Saturdays.
Does the client need to change Support at Home provider to see Alera?
No. Alera works as an associated provider alongside the registered provider that holds the plan. The client keeps their current provider and care manager.
Who can enquire about in-home physio or EP with Alera?
Care managers at registered providers, private clients and families can all enquire. DVA clients can ask about eligibility on enquiry. We do not offer occupational therapy or NDIS services.