Five signs your parent's physio has stopped progressing them

The clearest sign is that the exercises have not changed in months. Strength is built by asking a muscle to do slightly more than it already can. A program that stays the same stops adding anything fairly quickly, and what is left is a visit rather than a treatment.

This is not about a physiotherapist being bad at their job. It is usually about caseload, rostering, and nobody checking. Here is what to look for.

1. The same exercises, at the same difficulty

Look at the sheet on the fridge. If it is the one from a year ago, with the same repetitions and the same band, the program has stopped progressing. A program that is working gets harder, and the difficulty should be reviewed most visits.

2. Nobody can tell you what she is working toward

Ask her, then ask the physiotherapist, and see whether the answers match. “Improving her mobility” is not a goal. “Getting to the letterbox and back without stopping” is, because you can tell whether it happened.

3. There are no numbers, or nobody compares them

Something should be measured and written down — how many times she can stand from a chair in thirty seconds, how far she walks, how much help a transfer takes. One measurement is trivia. The same measurement three months apart is the only honest way to know whether any of this is working.

It is also the thing an NDIS reassessment runs on, which is why a thin report is usually a symptom rather than the problem.

4. A different physiotherapist keeps turning up

This is the one families accept most readily and should accept least. Progressing a program means knowing what was hard last month. Someone new starts her at the level she started at in March, takes the measurements slightly differently, and cannot tell whether a bad Tuesday is a bad day or a decline.

Large providers roster whoever is free. It is efficient for them and it quietly removes the thing that makes physiotherapy work.

5. Nothing happens between visits

One visit a week is one day. The Australian movement guidelines for over-65s ask for muscle strengthening on two or more days a week and balance work on three or more. No weekly visit covers that, so if there is no home program, or nobody ever asks what she managed, most of the week is doing nothing.

“What did you manage since last time?” should be asked every single visit, and the answer should change what happens next.

What good looks like

• The program changes as she changes, and she notices it getting harder
• Goals are written down in her words, and reviewed
• The same physiotherapist each visit, who remembers last month
• Something to do on the days between visits, and someone who follows it up
• You can see, in numbers, whether three months made a difference

What to ask, if you are not sure

Two questions settle it. What is she working toward, and how will we know when she gets there? And what has changed in the program since she started? A physiotherapist who is tracking the work answers both without hesitating.

If the answers are vague, that is worth raising before changing anything. Most of this is fixable by asking.

The questions in how to choose a mobile physio are the ones to ask before you commit, and our aged care page covers how visits work here.