Families are frequently told a discharge plan includes "therapy" without much explanation of which kind, or why. The three home therapy disciplines overlap in spirit — all of them are about independence — but they treat genuinely different problems.

Physical therapy: moving safely

Physical therapists deal with strength, balance, endurance, walking, and pain. In the home they are typically working on recovery after a joint replacement, fracture, stroke, or long hospital stay; balance and fall prevention; safe use of a walker, cane, or wheelchair; getting in and out of bed, a chair, the car, and the shower; and stair technique.

Consider PT when: the client is unsteady, has fallen or is afraid of falling, struggles to get up from a chair or the toilet, has stopped walking as far as they used to, or is recovering from orthopaedic surgery.

Occupational therapy: doing the daily things

Occupational therapists focus on the activities that fill an ordinary day — dressing, bathing, grooming, toileting, cooking, and managing the home. They retrain fine motor skill and upper body coordination, recommend and teach adaptive equipment such as reachers, tub benches, sock aids, and built-up utensils, adapt the home so tasks become possible again, and work on energy conservation for people who tire quickly. After a stroke or brain injury they also address the thinking side: sequencing, attention, and safety awareness.

Consider OT when: the client can walk but cannot dress or bathe themselves, has weakness or tremor in the hands, gets exhausted halfway through a task, or is no longer safe using the kitchen.

Speech therapy: communication and swallowing

Speech-language pathologists treat difficulty producing speech, finding words, or understanding others — common after a stroke or with Parkinson's disease and dementia. They also treat dysphagia, or difficulty swallowing, which is far more dangerous than most families realise: food or liquid entering the airway can cause aspiration pneumonia. An SLP evaluates swallowing, recommends safe food and liquid textures and positioning, and trains the family. They also work on memory, attention, and problem-solving after brain injury.

Consider speech therapy when: the client coughs or has a wet, gurgly voice during or after meals, is losing weight, has had pneumonia more than once, struggles to find words, or has become hard to understand.

Why more than one is common

Take a typical stroke recovery. Physical therapy gets the client walking safely again. Occupational therapy gets them dressing and bathing themselves and makes the bathroom workable. Speech therapy addresses the word-finding difficulty and the unsafe swallow. Meanwhile skilled nursing manages blood pressure, medications, and skin integrity, and an aide assists with personal care until independence returns. All of it runs on one plan of care, coordinated so the client is not repeating themselves to five different people.

How therapy at home differs from an outpatient clinic

Therapy in the home is practised on the client's own stairs, in their own bathroom, with their own furniture, and it removes the transport problem that causes so many people to skip appointments. The therapist sees the real obstacles rather than a description of them.

Therapy is provided under a physician-ordered plan of care. If you are not sure which discipline is needed, our nurse will assess and tell you — and will contact your physician for the order.