Allied health at home: what you can get

Allied health is the part of aged care that changes what a person can do, rather than doing it for them. It is also the part most often skipped, because it is less obvious than a cleaner and harder to ask for.

This is a plain guide to who does what, and how people usually get to them.

This is general information, not advice. Which clinician a particular person needs is a clinical question, and the GP is the right place to start.

Start with the GP

Almost every route into allied health runs through the general practitioner. They can refer, they can set up the arrangements that make some of it affordable, and they can tell you which discipline you actually need, which is not always the one you assumed.

Book a longer appointment than usual and bring a list. “She is unsteady, she has stopped cooking properly and her feet are sore” is enough to work with.

Who does what

Physiotherapy. Strength, balance, mobility and pain. This is the discipline with the best evidence behind it for keeping older people on their feet, and a home programme of unglamorous exercises does more to prevent falls than most equipment. Also the right call after a fracture, a joint replacement or a long hospital stay.

Occupational therapy. How you manage the actual tasks of a day, and the equipment and modifications that make them possible. An OT is who assesses the house: which rail, which wall, which height, whether a ramp will work. If you are heading toward home modifications or equipment, this is the person you need first.

Podiatry. Feet, nails, corns, callus, footwear and the foot problems that come with diabetes. Enormously underrated. Sore feet stop people walking, and a person who stops walking gets weaker at speed. For many older people this is the single highest-value regular appointment they have.

Dietetics and nutrition. Weight loss, poor appetite, diabetes, and eating well when cooking has become difficult. Worth involving early rather than after significant weight has gone. Our guide on when an older person stops eating properly covers what tends to sit behind it.

Speech pathology. Two quite different jobs: swallowing difficulty, and communication after a stroke or with progressive conditions. Coughing or choking during meals is a reason to ask for this rather than to adjust the food yourself.

Exercise physiology. Structured exercise for chronic conditions, including heart disease, diabetes and osteoporosis. Overlaps with physiotherapy and often works alongside it.

Psychology and counselling. Depression, anxiety, grief and adjustment. Late-life depression is common, treatable, and routinely mistaken for ordinary ageing by everyone including the person who has it.

Audiology and optometry. Hearing and vision. Both are dull and both matter more than almost anything else on this list, because hearing loss drives isolation and confusion, and poor vision drives falls. Get them checked before assuming a memory problem.

Continence advice. Specialist nurses and physiotherapists who work on bladder and bowel problems, which are frequently improvable rather than permanent. See continence support at home.

Diabetes education. Practical management of diabetes day to day, which for an older person often means simplifying a regime rather than intensifying it.

Massage, myotherapy, osteopathy and chiropractic. Manual therapies, mostly for musculoskeletal pain. Availability and funding for these under aged care varies a good deal, so ask before you commit.

Music and art therapy. Used most in dementia care, and genuinely effective for agitation, mood and engagement where conversation has become difficult.

Therapy assistants. Work under a clinician’s plan, delivering the repetitive parts of a programme more often and more affordably than the clinician could. A good use of a budget once a plan exists.

How to make it actually work

One assessment, then repetition. A single physio visit achieves very little. The value is in a programme that gets done three times a week for months, which is a support worker’s job as much as a clinician’s.

Get the plan written down. Not in a folder in a car. Written into the household’s own record so anyone who comes can follow it. At Aldera that lives in the One Story, because a programme nobody can find is a programme nobody does.

Sequence it. Feet and eyes before a falls programme, because there is no point training balance while someone cannot see the step or bear weight on a sore foot.

Do not let it be one-off. The commonest pattern is a single assessment, a printed sheet, and nothing after. Ask specifically what the review interval is and who books it.

Who arranges it

You can do all of this yourself: get the GP referral, ring around, book, and keep the plans straight. Plenty of people do.

If you would rather not, arranging it is part of what we do. That means finding and booking the right clinician, getting the referral moving with the GP, holding one plan that every professional and every support worker works from, and being the number you ring when something changes. The clinical work is delivered by the physiotherapist, nurse, dietitian or psychologist who is qualified to do it. What we hold is the coordination, so that a household is not the postal service between seven professionals.

If you already have clinicians you trust, we work to their plans rather than replacing them.

Where support workers fit

A support worker is not an allied health professional and should not be presented as one. What they can do is make the clinician’s work happen: prompting and supervising the exercise programme, getting someone to and from appointments, following the eating plan a dietitian set, and reporting back what actually happens between visits.

That last part is worth more than it sounds. The clinician sees the person for forty minutes a month. Someone who is there weekly knows whether the programme is being done, and whether it is helping.

For current aged care information start at myagedcare.gov.au; the Department of Health and Aged Care publishes program detail. To talk through having any of this arranged and then followed between visits, ring us and a person will answer.