Physiotherapy for Dementia: Staying Mobile and Safer at Home

Dementia is often thought of as a condition of memory, but it affects movement too. Slower reactions, weaker muscles, poorer balance and trouble doing two things at once can all make walking and everyday tasks harder, and raise the risk of falls. Physiotherapy for dementia aims to keep people moving, confident and as independent as possible for as long as possible, ideally in the home they know.

This guide explains how dementia affects movement, what the research says about exercise, what a home physiotherapy session looks like, and practical tips for carers. It is general information only, not medical advice. Everyone with dementia is different, so talk to the person’s GP about what suits them.

The short answer

• Dementia can cause physical changes, including slower reaction time, weaker muscles, poor coordination and balance problems that lead to falls.
• Physiotherapists can help with strength, balance, walking, walking aids, pain and safe ways to move, and can train families and carers too.
• Research suggests exercise may help people with dementia manage daily activities, and one Australian trial of strength and balance training reduced falls in aged care residents with cognitive impairment or dementia.
• Sessions work best when they are short, familiar and built around real daily tasks.
• Funding options include a Medicare GP chronic condition management plan, Support at Home, DVA and private health insurance.

How dementia affects movement

Dementia Australia estimates that 446,500 Australians are living with dementia in 2026, including around 113,900 people in Victoria. Each person experiences it differently, but a joint position statement from the Australian Physiotherapy Association and Dementia Australia lists physical problems associated with dementia, including:

• slower reaction time
• weaker muscles
• poor coordination
• trouble doing more than one thing at a time, such as carrying a cup of tea while walking
• balance problems, including falls

There are indirect effects too. Changes in how the brain processes what the eyes see can make it harder to find the way, judge spaces or recognise objects such as furniture. Communication changes can mean pain goes unnoticed or untreated, and unmanaged pain can affect walking, sleep and mood.

What a physiotherapist can help with

The same position statement describes a broad role for physiotherapists in dementia care, including:

• early care after diagnosis to support strength and balance through exercise and physical activity
• training families and carers to help with everyday activities
• advice about walking aids, such as walking sticks and walking frames
• advice about more complex movement issues, including wheelchairs and hoists
• working with families and carers on changed behaviours that may relate to unmet needs, such as pain or discomfort
• assessing non-verbal signs of pain and working with other health professionals to manage it
• treatment for other physical conditions, such as stroke or arthritis

Physiotherapy is often most useful early, while the person can still learn and practise new routines. It remains valuable later on, when the focus shifts to comfort, safe transfers and supporting carers.

What the evidence says about exercise and dementia

The research is encouraging, but it helps to be clear about what it does and does not show.

• Daily activities. A Cochrane review of 17 trials found promising evidence that exercise programs may improve the ability of people with dementia to carry out activities of daily living. The authors advised caution because the trials varied widely and the evidence quality was low.
• Falls. In the Australian Sunbeam trial, aged care residents with mild to moderate cognitive impairment or dementia did progressive strength and balance training twice a week for 25 weeks. The rate of falls in the exercise group was 50% lower than in the usual care group, and balance and the ability to stand up from a chair improved, with no serious adverse events. This study was in residential aged care, so results for people living at home may differ.
• Thinking and memory. Findings are mixed. The Cochrane review found no clear evidence that exercise improved cognition. A Dementia Australia expert webinar notes research showing exercise can reduce decline in overall thinking skills and working memory, with less evidence for other types of thinking.

The practical takeaway is that regular, well-chosen exercise is worth doing for strength, balance and everyday function. Any benefit to memory is a bonus rather than a promise.

What a home physio session looks like

Home is often the best place for physiotherapy when someone has dementia. Familiar surroundings reduce confusion, there is no stressful trip to a clinic, and the physio can practise the exact tasks that matter, in the exact places they happen.

The first visit

At Khy Physio, a first appointment typically takes around 45 to 60 minutes. The physio talks with the person and their family about their health, routines, any falls and what they would like to keep doing. They then check strength, balance and walking, and look at the home itself: the bed, the favourite chair, the route to the toilet at night, steps, rugs and lighting. We encourage family members and carers to join in, and our team can communicate in English, Mandarin, Cantonese and Sinhala.

Ongoing sessions

Follow-up sessions usually focus on practical, repeated practice, such as:

• standing up from and sitting down in their own chair
• walking safely around the house and garden, with or without an aid
• getting in and out of bed
• simple strength and balance exercises that can be repeated between visits
• showing carers how to prompt and support movement without taking over

For more on reducing falls risk at home, see our guide to falls prevention for older people.

Tips for carers

Carers make a huge difference to how much a person with dementia gets out of physiotherapy. These everyday strategies can help:

• Keep a routine. Try to do exercises at the same time each day, when the person is usually at their best.
• Show, do not just tell. Demonstrate an exercise and do it together. Give one simple instruction at a time.
• Keep it short. A few minutes of practice spread through the day often works better than one long session.
• Build movement into daily life. Walking to the letterbox, folding washing standing up or a stroll around the garden all count.
• Watch for signs of pain. Grimacing, restlessness, guarding a body part or refusing to move can all point to pain. Mention these to the GP and physio.
• Make the home easier to move around. Good lighting, especially at night, a clear path to the toilet and well-fitting shoes all help.
• Look after yourself. Ask the physio to show you safe ways to help with standing and walking, so you protect your own back.

If the person’s mobility or confusion changes suddenly, over hours or days, contact their GP promptly, as this can signal an illness that needs treatment. If they do fall, our guide on how to get up after a fall explains what to do.

For information and support, you can call the National Dementia Helpline on 1800 100 500.

Funding for dementia physiotherapy

• Medicare. With a GP chronic condition management plan and a referral, you can claim a rebate for up to 5 allied health services a year. From 1 July 2026 the physiotherapy rebate is $63.40.
• Support at Home. Physiotherapy is a clinical support, so there is no participant contribution. See our guide to Support at Home physiotherapy.
• DVA. Veteran Card holders can access physiotherapy with a referral, subject to their card type.
• Private health insurance extras or private payment.

Frequently asked questions

Is it worth starting physio if dementia is already advanced?

Often, yes. The goals change, but physiotherapy can still help with comfort, safe transfers, positioning, pain and teaching carers how to help safely.

What if the person does not remember their exercises?

That is common and expected. Exercises that are built into daily routines, practised with a carer and prompted with simple cues tend to work better than written programs alone.

Can physio stop falls in people with dementia?

No treatment can prevent every fall, but strength and balance training reduced falls in one Australian trial of aged care residents with cognitive impairment or dementia. A physio can also look at walking aids, footwear and hazards at home.

Can family members be present during sessions?

Yes, and we encourage it. Family and carers can learn the exercises, give support between visits and share useful information about how the person is going.

Do you visit people with dementia in aged care homes?

Yes. We visit people at home and in residential aged care homes across Melbourne and the Geelong region, and coordinate with the care team.

Book dementia-friendly physiotherapy at home

If someone you care for is living with dementia and becoming less steady on their feet, physiotherapy at home can help them keep moving safely. Make a referral or contact our team on 03 8824 0712 and we will talk through your situation and arrange a first visit.

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