A rehabilitation home programme template families can follow, with sample activities tied to the household's daily routine.
✓Every discipline's advice on one page
✓Activities tied to daily routines
✓Weekly log for the family
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What's inside
What We Are Working On Together
Daily Activities
How Family Members Can Help
Safety at Home
Weekly Log
Who to Contact
Questions for the Next Review
Preview · 7 sections
Rehabilitation Home Programme
Patient
Date given
Main carer
Review date
Key worker
Clinic phone
What We Are Working On Together
Our goals in plain wordsThe shared goals, written the way the patient and family said them.
Daily Activities
Activity
How to Do It
When in the Day
How Often
Set By
Moving and walking
Washing, dressing and eating
Talking, reading or swallowing strategies
Memory, planning and mood
How Family Members Can Help
Family Member or Carer
What They Help With
How to Help
Safety at Home
☐ Walking aid within reach, including at night
☐ Clear, lit path to the bathroom
☐ Meals and drinks prepared as the team advised
☐ Rest breaks planned through the day
☐ Clinic phone number saved on the carer's phone
Weekly Log
Day
Activities Done
How It Went
Tiredness or Worries
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Who to Contact
Who to contact and whenClinic number, key worker, hours, and which problems need a same-day call.
Questions for the Next Review
Questions for the next review
How to fill it in
1
What We Are Working On Together
Copy two or three shared goals in the words the patient and family used.
More guidance
Copy two or three shared goals in the words the patient and family used at the goal-setting meeting, leaving the measurable team wording in the goal plan. This line is what keeps people practising on a tired day, so it should sound like something the patient wants. If the patient chose the order, keep it.
2
Daily Activities
One row per activity: simple steps, when in the day, how often, who set it.
More guidance
One row per activity. Describe it in short steps a carer can follow, attach it to a moment in the household's day (after morning tea, before the evening serial, at lunch), say how often, and name the team member who set it so questions reach the right person. A photo or short video taken during a session helps more than a diagram. Leave out anything the patient should do only with a therapist present.
3
How Family Members Can Help
Give each helper a named role, and say how much to step in.
More guidance
Give each helper a role. In joint families several people may help on different days, so write what each person does and how: how much to step in, when to wait, and what to praise. If speech and language therapy is involved, include communication advice such as giving time to answer and not finishing sentences. Include a paid attendant by name if there is one.
4
Safety at Home
List the team's safety points in plain language and tick them off with the family.
More guidance
List the safety points the team has given, in plain language, and tick them off with the family before discharge. Typical items are where the walking aid stays, night lighting, bathroom set-up, food and drink as the speech therapist advised, and rest. Add what the clinic wants the family to do if something goes wrong, such as a fall, choking or new weakness, using the clinic's own advice.
5
Weekly Log
Ask the family to note daily what was done, how it went, and any worries.
More guidance
Ask the family to fill in one line a day: what was done, how it went, and anything that worried them, such as tiredness, pain or a near-fall. A photo of the log sent before the next review helps the team prepare. Patterns, like activities skipped every Sunday when relatives visit, show where the programme needs to fit the household better.
6
Who to Contact
Give the clinic number, key worker, hours, and which problems need a same-day call.
More guidance
Give the clinic's phone number, the key worker's name, the hours someone will answer, and which problems need a same-day call rather than waiting for the next visit. Add where to go in an emergency. Families in India often send a message instead of calling, so say whether messages are read and when, so nobody waits for a reply that is not coming.
7
Questions for the Next Review
Leave space for questions the family writes down during the week.
More guidance
Leave space for the family to write questions as they come up during the week. Questions noted at home, when a problem is fresh, are usually more useful than those remembered in the waiting room. Read them at the start of the next review so the family's agenda is covered before the team's.
Rehabilitation home programme template and sample: filled sample
Fictional entries, initials only, showing the level of detail to aim for. Impression and summary sections are left for the treating clinician.
What We Are Working On Together
1. Get to the bathroom at night with only the walker. 2. Sit with the family at the dining table for meals. 3. Talk on the phone with my brother in Pune.
Daily Activities
Sit-to-stand from the dining chair: feet back, lean forward, push up with both hands on the armrests. Five times before lunch and five before dinner. Wife stands on his left side. Set by: PT (Mr D.).
How Family Members Can Help
Son (evenings): walks with Appa to the dining table, standing on his left side. Grandchildren: play the picture-naming card game after school and wait for him to find the word before helping.
Safety at Home
Walker stays on the left side of the bed at night. Bathroom light stays on. Tea and water as the speech therapist advised; sit upright for all meals.
Weekly Log
Wed: sit-to-stand done twice; walked to the dining table at dinner. Tired after visitors in the afternoon, so skipped the picture cards.
Who to Contact
Key worker: Ms A. (OT). Clinic phone answered Monday to Saturday, 9 am to 6 pm. Call the same day after a fall, new pain or a choking episode. At night, go to the nearest hospital emergency department.
Team home programme vs single-discipline home exercise programme
Team home programme
Single-discipline home exercise programme
Covers
Activities from every discipline in one daily plan
One therapist's exercises
Organised by
The household's daily routine
Exercise type
Main user
Patient and family carers together
Usually the patient
Includes
Carer roles, safety, contacts, weekly log
Exercises, repetitions and precautions
Updated
At each team review and at discharge
When that therapist progresses it
Tips and mistakes to avoid
Do
Ask the carer to demonstrate each activity before they leave, rather than only explain it.
Write in the family's reading language, and note which language each carer reads.
Tie activities to daily routines such as prayers, meals or the evening serial; clock times are easily forgotten.
If a paid attendant will do most daily help, train them directly and give them a copy.
Where a clinic uses healhab's Family Portal, families it has granted access can see published documents such as this programme.
Avoid
Including every exercise each discipline wants; long programmes tend to be abandoned within days.
Writing clinical shorthand such as “STS × 5, SBA” that families cannot decode.
Leaving out who to call and when.
Teaching only the relative who attends sessions when someone else does the daily care.
About this home programme
A rehabilitation home programme tells the patient and their carers what to practise at home, when in the day, and how to do it safely, combining advice from every discipline into one plan. This free template is written for families: goals in plain words, activities tied to daily routines, carer roles, a weekly log and clear contacts.
At discharge from inpatient or day rehab
Between outpatient sessions with several disciplines involved
When a new carer or paid attendant takes over
Before a festival, wedding or native-place visit pauses sessions
Read more
Patients often go home with three or four separate sheets, one per discipline, and whatever fits least easily into the day gets dropped. This template puts everything on one plan arranged around the household's own day.
The key worker assembles it and each therapist writes their own row. Keep it to four to six activities, and go through it with the patient and main carer before they leave.
Questions
What is a rehabilitation home programme?+
It is a written plan for practice at home after or between rehab sessions. It combines advice from physiotherapy, occupational therapy, speech therapy, psychology and nursing into one set of daily activities, with safety points, carer roles and contacts.
Who writes the home programme on a multidisciplinary team?+
Usually the key worker puts it together, and each discipline writes and checks its own activity rows. One person should go through the finished programme with the patient and main carer.
How many activities should a home rehab plan include?+
Few enough to fit into the household's day, often four to six. Choose the activities that move the patient's shared goals most and drop the rest until the next review.
How do we make a home programme work in a joint family?+
Give each family member a named role and a time of day, and train each person who will help. Include the relative who makes household decisions in the discussion, even if they will not do the daily practice.
Should the programme include repetitions and sets?+
Where a therapist has set them, yes, in plain words in the activity row. Say what to do if an activity feels too easy or too hard; usually that means carrying on as set and asking at the next review.
How often should the home programme be updated?+
At every team review or outpatient visit, and whenever something changes at home, such as a new carer or a move to another relative's house.
Is there a filled sample of this home programme?+
Yes. Each section guide on this page shows a fictional sample entry, using initials only. Activities, repetitions and safety advice must come from your own team, so use the samples as a guide to wording and detail.
