Physiotherapists as an Active Partner in the Multidisciplinary Team

Falls, reduced mobility and functional decline remain significant clinical challenges within residential aged care. We know that these issues are rarely caused by a single factor. A resident’s mobility can be influenced by their medical conditions, medications, pain, cognition, nutrition, environment, fatigue, strength, balance and many other factors.

This is precisely why a strong multidisciplinary approach is so important.

Within this model, physiotherapists have a particularly valuable contribution to make. Every day, physiotherapists observe residents moving, transferring, walking, exercising and participating in functional activities. These interactions provide an opportunity to identify changes in a resident’s presentation that may not be immediately apparent through routine documentation or during other aspects of care.

The opportunity for aged care providers is to ensure these observations are not viewed in isolation but are actively incorporated into the broader clinical picture.

Physiotherapy Is More Than Mobility and Exercise

Physiotherapy in residential aged care is sometimes viewed primarily through the lens of falls prevention, exercise programs, mobility assessments and rehabilitation.

While these remain fundamental components of physiotherapy practice, the clinical value of the physiotherapist extends much further.

A physiotherapist’s assessment can provide important information about:

• changes in gait, balance and mobility
• changes in transfer ability
• reduced exercise tolerance
• pain and its impact on function
• postural dizziness or symptoms suggestive of orthostatic intolerance
• changes in strength and endurance
• altered motor performance
• changes in functional participation
• the impact of medication timing on movement and function
• changes following a medication adjustment
• emerging deterioration in physical function.

These observations can provide valuable information to nursing staff, general practitioners, nurse practitioners, pharmacists, occupational therapists and other members of the multidisciplinary team.

The physiotherapist is not replacing the role of another discipline. Rather, they are contributing a different clinical lens to the overall picture.

That is where the real value of multidisciplinary care lies.

Connecting Medication With Function

Medication management is a good example of where this collaborative approach can be particularly valuable.

Physiotherapists do not prescribe or alter medications. However, they are often in a position to observe the functional consequences that may occur following medication changes or as a resident’s medication profile evolves.

For example, a resident may begin demonstrating:

• increased dizziness during transfers
• reduced exercise tolerance
• changes in gait quality
• increased fatigue or sedation
• changes in balance
• increased pain or reduced participation
• fluctuations in mobility throughout the day
• changes in motor performance associated with medication timing.

These observations may provide important information for the broader clinical team.

The physiotherapist can document the functional change, communicate the concern through the appropriate clinical pathway and recommend that the resident’s presentation be reviewed by the relevant medical practitioner or pharmacist.

This is not an expansion of physiotherapy into prescribing.

It is simply good multidisciplinary clinical practice.

Seeing the Whole Resident

One of the strengths of residential aged care is the opportunity to bring different clinical perspectives together.

Consider a resident experiencing increasing difficulty walking.

The physiotherapist may identify a change in gait, balance and exercise tolerance.

The nurse may have observed increasing fatigue, changes in continence, altered appetite or a recent medication change. The pharmacist may identify a medication-related consideration. The GP or nurse practitioner may have broader medical information that provides context for the change.

The occupational therapist may identify changes in the resident’s ability to complete personal care or other daily activities. Individually, each observation provides a piece of the puzzle.

Together, they provide a much more complete understanding of what is happening for that resident. This is the strength of a genuinely multidisciplinary model.

Physiotherapists Can Be an Early Clinical ‘Signal’

Physiotherapists are often seeing residents in situations where subtle functional changes become visible.

A resident who is becoming less steady, taking longer to transfer, requiring more assistance or demonstrating reduced endurance may not yet have experienced a significant incident or obvious clinical deterioration. However, the physiotherapist may recognise that something has changed. This is an important clinical opportunity.

Rather than waiting for the change to become a falls incident, hospital admission or significant functional decline, the observation can be communicated to the broader team and investigated proactively.

This is particularly important in residential aged care, where early identification and intervention can make a meaningful difference to maintaining function, independence and quality of life.

Parkinson’s Disease: An Excellent Example of Multidisciplinary Value

Parkinson’s disease provides a particularly clear example of the value of combining clinical perspectives. Medication timing can have a significant impact on a resident’s movement, gait and functional performance.

A physiotherapist may observe that a resident is moving considerably better during one therapy session than another, or that their gait, balance or transfer ability fluctuates throughout the day.

Nursing staff may have information regarding medication administration times and changes in the resident’s presentation. Bringing these observations together can help the treating medical team understand the relationship between medication timing and functional performance.

The physiotherapist does not need to make a medication recommendation to add significant clinical value. Their role is to identify, assess, document and communicate the functional presentation. That information can then inform the appropriate clinical decision-making process.

The Full Scope of Physiotherapy Practice

For aged care providers, this raises an important question: Are we fully utilising the clinical expertise of our physiotherapists?

A contemporary physiotherapist’s role extends well beyond delivering an exercise program. Physiotherapists are highly skilled clinicians who assess movement, function, strength, balance, mobility, pain and physical performance. They use clinical reasoning to identify contributing factors, establish goals, implement interventions and monitor change over time.

Importantly, they also work as part of a broader healthcare team. The Australian physiotherapy scope of practice framework recognises that physiotherapy practice is influenced by professional competence, clinical governance and the context in which care is delivered. Effective communication and collaboration are therefore fundamental components of contemporary physiotherapy practice.

For aged care providers, utilising physiotherapists to their full scope does not mean asking them to take on the responsibilities of other disciplines.

It means ensuring that their existing clinical expertise is recognised, captured and integrated into resident care.

Moving From a ‘Therapy Service’ to a Clinical Resource

There is an important distinction between viewing physiotherapy simply as a service that provides assessment and therapy sessions and recognising physiotherapy as an ongoing clinical resource within the facility.

A physiotherapist who is well integrated into the multidisciplinary team can contribute to:

• Falls prevention – Through assessment, intervention, identification of contributing factors and communication of emerging changes.
• Functional decline prevention – Through early identification of changes in mobility, strength, endurance and participation.
• Clinical review following incidents – Including post-falls assessment and identification of changes that may require broader clinical review.
• Pain and mobility management– By identifying how pain is affecting movement, function and participation.
• Medication-related functional observations – By recognising and communicating changes in mobility, balance, alertness or exercise tolerance.
• Equipment and mobility recommendations – Through assessment of the resident, their environment and their functional requirements.
• Manual handling and staff education– Supporting the broader care team to safely assist residents while promoting independence and dignity.
• Reablement and restorative care – Helping residents maintain or regain function through meaningful, goal-directed activity.
• Multidisciplinary clinical communication – Providing another clinical perspective to inform broader assessment and decision-making.

This is where physiotherapy can become an even greater asset to an aged care organisation.

Creating Better Clinical Connections

The opportunity is not necessarily to create more meetings, more paperwork or more processes. It is about creating better clinical connections.

Simple strategies can make a significant difference, including:

• encouraging physiotherapists to communicate clinically significant functional changes to nursing staff and the broader care team
• incorporating relevant medication-related functional observations into falls and mobility assessments
• establishing clear escalation pathways to GPs, nurse practitioners and pharmacists
• involving physiotherapists in relevant case conferences and Residential Medication Management Reviews
• encouraging nursing and physiotherapy teams to discuss changes in mobility, pain, cognition, endurance and functional performance
• reviewing residents following significant medication changes where there is a potential functional impact
• ensuring physiotherapy recommendations are communicated effectively and incorporated into the resident’s broader care plan.

These approaches do not require physiotherapists to work outside their scope.

They simply allow the organisation to better utilise the expertise that is already available.

A More Connected Model of Care

The most effective aged care environments are those where disciplines do not operate in silos.

• The physiotherapist does not need to be the expert in everything.
• The pharmacist does not need to assess mobility.
• The nurse does not need to conduct a comprehensive physiotherapy assessment.
• The occupational therapist does not replace the physiotherapist.
• The GP does not need to observe every functional change firsthand.

Instead, each discipline contributes its own expertise. When those observations are shared effectively, the resident benefits from a much more complete clinical picture.

This is the essence of multidisciplinary care.

The Opportunity for Aged Care Leaders

For facility managers and clinical leaders, there is an opportunity to look beyond the traditional question of:

“What therapy hours are we receiving?” and instead consider, “How effectively are we using the clinical expertise of our physiotherapy team?”

• Are physiotherapists included in the conversations where their clinical observations could add value?
• Are they being encouraged to identify and escalate changes rather than simply respond to referrals?
• Are their recommendations integrated into the broader care plan?
• Are nursing and therapy teams communicating effectively about functional changes?
• Are physiotherapists being utilised for clinical education, manual handling, falls prevention, reablement and multidisciplinary problem-solving?
• And importantly, are organisational systems making it easy for physiotherapists to communicate what they are seeing?

The Bottom Line

Physiotherapy has an important role to play in residential aged care—not only as a therapy service, but as a valuable clinical resource within the multidisciplinary team.

Physiotherapists see residents in movement. They observe function in real time. They identify changes. They monitor response to intervention, and they often have valuable insights into factors affecting mobility, participation and falls risk.

When those observations are effectively communicated to nurses, medical practitioners, pharmacists, occupational therapists and the broader care team, they can contribute to earlier identification of clinical concerns, more informed decision-making and more coordinated resident care. The opportunity for aged care providers is not to redefine physiotherapy. It is to fully utilise it.

When physiotherapists are supported to work to their full professional scope and are genuinely integrated into the multidisciplinary team, they can contribute far more than individual therapy sessions. They become an important part of the organisation’s broader clinical capability—helping teams identify change earlier, coordinate care more effectively and keep residents moving, participating and living as independently as possible. That is the real value of multidisciplinary physiotherapy in aged care.