Assistive Technology Reviews are not optional - they're a legislative and regulatory requirement.
- Lauren H
- 2 days ago
- 6 min read
If you're an Occupational Therapist working in community aged care or disability services, you've probably had this conversation: You recommend a review period for a high risk piece of equipment, and the client, family, or funding body pushes back. "That's not required," they say. "I'm not spending my funding on that"
There is often push back from clients, families and even providers, particularly when the 'budget is tight'. The reality is that assistive technology reviews are not optional. They are actually a regulatory and legislative requirement. Most Occupational Therapists known that, but the request still falls flat, even when it's communicated.
What The Standards Actually Say
Equipment that was safe and appropriate six months ago can become a serious risk today. That's why regular reviews are built into the regulatory frameworks governing aged care and disability services in Australia.
Aged Care Quality Standards
Standard 4 (The Environment) states that equipment must be "safe, appropriate and well-maintained." That word appropriate is doing a lot of work. It doesn't just mean the equipment functions - it means the equipment still matches the person's current needs.
If someone's mobility has improved, a shower chair that was essential in January might create a new fall risk (wet transfers) by June. If their cognition has declined, bed rails installed for positioning support might now be an entrapment hazard.
Standard 5 (Clinical Care) goes further: care must be "person-centred, evidence-based, safe, effective, and coordinated... that meets changing clinical needs." Not met past tense — meets present tense. Equipment is part of clinical care, and it needs to change when the person changes.
NDIS Assistive Technology Guidelines
The NDIS takes an even more explicit position on this. Their Assistive Technology Product Risk Table classifies equipment into low-risk and higher-risk categories.
Bed rails, bed sticks, shower chairs, hoists, wheelchairs, and pressure care equipment all fall into the higher-risk category. And here's the key part: higher-risk AT requires reassessment by a qualified practitioner if there have been "significant changes in physical capacity" since the equipment was last supplied.
AHPRA Code of Conduct & OT Competency Standards
Even if you're not working under aged care or NDIS funding, you're still bound by professional standards.
The Australian OT Competency Standards require registered occupational therapists to:
Provide evidence-based care
Monitor outcomes
Modify recommendations when client needs change
Overlooking equipment already in place that no longer matches the person's needs or failing to identify when it's become unsafe may be a breach of professional standards.
Work Health and Safety Act 2011
The Work Health and Safety Act applies to all Australian workplaces, including in home care environments for aged care workers.
While most Australian jurisdictions adopted harmonized Work Health and Safety (WHS) laws based on the 2011 model, Victoria (VIC) remains the exception, operating under the Occupational Health and Safety Act 2004 (VIC).
Both systems place primary duties on a PCBU (Person Conducting a Business or Undertaking) to ensure safety. This means the client themselves and the provider have an obligation to ensure equipment that support workers are using is safe and fit for purpose.
Why Equipment Becomes Unsafe (Even When It "Looks Fine")
As OTs, we understand that equipment doesn't exist in isolation. It exists in relationship to a person whose function, cognition, environment, and needs are constantly changing. Here's what can go wrong:
1. The Person's Function Has Changed
Improved function: They can now stand safely for 10 minutes, but they're still using a shower chair. The wet transfer getting on and off the chair is now a greater fall risk than standing would be. Keeping the equipment creates a hazard that didn't exist before.
Declined function: They needed a single-point stick last year. Now their balance has deteriorated and they need a four-wheeled walker. But the cane is "working fine" for them, until it isn't, and they fall.
2. Cognition Has Changed
Bed rails were installed when the person had mild cognitive impairment and used them appropriately, with consent, for rolling support. Six months later, they have moderate dementia and are now trying to climb over the rails at night to get to the bathroom.
The equipment didn't change. The person did. The rails have gone from helpful to dangerous.
3. Equipment Wears Out or Gets Used Incorrectly
Equipment can develop loose joints. Shower chairs get positioned on uneven floor tiles. Pressure cushions lose their inflation. Equipment that was set up correctly six months ago can drift into unsafe configurations and people often don't notice until something goes wrong.
4. The Environment Has Changed
Mary got new carpet. Now her kitchen trolley catches. John is using the bathroom closer to his bedroom now. The support worker is now lifting the shower commode over the lip. The equipment is might be fine, but the environment changed, so the risk has shifted.
When Managing Push Back: What To Say
The most common objection is "but they're used to it." That's understandable as familiarity often feels safe. But familiarity with unsafe equipment doesn't make it safe.
If they still decline your recommendation, this should really be documented formally by the provider as dignity of risk (unless there is a support worker involved, and then there are obligations under the WHS act).
Cover yourself by recording:
What you recommended and why
What the risks are of continuing with the current setup
That the client/family was informed of the risks
That they chose to proceed against clinical advice
When you'll review again
The recommendation stays on file. Your professional obligation was to assess and advise. Their right to decline doesn't remove your duty to document. Want to build confidence on managing duty of care and dignity of risk, check out our on-demand webinar on the topic.
The Bigger Picture: Equipment Reviews Protect Everyone
Regular equipment reviews protect:
The client - from preventable falls, injuries, and functional decline
The family - from the trauma of a preventable incident
The OT - from professional and legal liability
The provider - from Quality Standards non-compliance
The Bottom Line
Unfortunately, sometimes we need to be comfortable being the bearers of bad news. And removing or changing equipment can mean the loss of independence for some people. That's hard and comes with a lot of grief and loss.
Practice Insight! Having an objective checklist that outlines the actually performance capabilities required, can be a helpful way of getting this message across.
In having and documenting these conversations, you're complying with:
Aged Care Quality Standards (Standards 4 and 5)
NDIS Assistive Technology Guidelines
AHPRA Code of Conduct
Australian OT Competency Standards
When Equipment Reviews Intersect With Restrictive Practice
Equipment reviews often uncover restrictive practices that were never formally classified as such.
Bed rails that prevent someone from getting out of bed when they want to? That's environmental restraint under the Aged Care Act, even if the family consented.
Chair tables that confine someone to their seat? Physical restraint.
Sensor mats that trigger an alarm every time someone tries to stand independently? Potentially restrictive, depending on how it's being used and whether the person has the capacity to consent.
The Aged Care Rules 2025 are explicit: if a restrictive practice is used, it must be documented in the care plan in advance.
If you're reviewing equipment and discovering it's being used restrictively — or if families are requesting equipment that would constitute restraint — you need to know how to navigate this conversation before it becomes a compliance issue.
Join Our Upcoming Webinar: Restrictive Practice in Community Aged Care — A Positive Behavioural Support Approach
Joined by a Behavioural Support Specialist, we will cover:
✅ What are your obligations in terms of restrictive practice and behavioural support under the Aged Care Act.
✅ How to identify what is classified as a restrictive practice - and what is not.
✅ Learn how to use a positive behavioural support in your assesssment and interventions, using a framework design specific for community aged care.
✅ When to escalate and who to escalate to (including elder abuse considerations)
✅ Real case studies from community OT practice
✅ Get a number of practice resources and templates including a Behavioural Support Assessment Template, Behavioural Support Handover Template
This webinar is specifically for OTs working in community aged care and Support at Home services. We'll give you practical tools you can use the next day.
Need Help Explaining Equipment Reviews To Clients?
We've created a free downloadable handout you can give to clients and families that explains:
Why reviews are required under Australian law
What happens during a review
What the possible outcomes are
What to do if they disagree with the recommendation
This plain-language resource helps families understand that equipment reviews aren't optional, they're a safety requirement. And it gives OTs, a professional, evidence-based document to support those difficult conversations.
References:
Aged Care Quality and Safety Commission. (2025). Strengthened Aged Care Quality Standards.
NDIS. (2024). Assistive Technology Product Risk Table. National Disability Insurance Agency.
Occupational Therapy Board of Australia. (2018). Australian Occupational Therapy Competency Standards.
AHPRA. (2022). Code of Conduct for Registered Health Practitioners.
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