RST vs. PSW vs. Physiotherapist: Understanding Your Options
By Rohit Tamhane, Founder · Updated July 2026 · 10 min read
When your aging parent needs support, the alphabet soup of care roles (RST, PSW, PT, OT) can be overwhelming. Each serves a different purpose, and understanding the distinction helps you choose the right support at the right time. This guide compares the three most common options families in Toronto encounter.
RST: Rehabilitation Support Therapist
Focus: Proactive exercise, independence maintenance
What they do
- • Designs and supervises in-home exercise programs
- • Balance training, strength building, fall prevention
- • IADL-mapped exercises (cooking, mobility, self-care)
- • Cognitive exercises and dual-task training
- • Aquatherapy sessions
- • Progress tracking and program adjustment
What they don't do
- • Personal care (bathing, dressing, toileting)
- • Medical procedures or wound care
- • Prescribe medications or medical treatments
Best for: Seniors who are still fairly independent but showing early signs of decline: unsteadiness, weakness, reduced activity, fear of falling. The goal is to maintain and rebuild capacity.
Typical cost: $45-$85/hour (private pay)
PSW: Personal Support Worker
Focus: Daily living support and personal care
What they do
- • Bathing, dressing, grooming assistance
- • Meal preparation and feeding support
- • Medication reminders
- • Mobility assistance and transfers
- • Companionship and supervision
- • Light housekeeping
What they don't do
- • Design exercise or rehabilitation programs
- • Provide therapeutic interventions
- • Clinical assessment or medical procedures
Best for: Seniors who can no longer perform basic daily tasks independently and need hands-on help with bathing, dressing, eating, or constant supervision.
Typical cost: $28-$42/hour (private pay)
PT: Physiotherapist
Focus: Clinical assessment, treatment plans, acute rehabilitation
What they do
- • Diagnose movement disorders and conditions
- • Create treatment plans for specific injuries/conditions
- • Post-surgical rehabilitation protocols
- • Prescribe assistive devices
- • Clinical assessments and referrals
- • Manual therapy and modalities
What they don't do
- • Provide ongoing daily exercise supervision
- • Personal care support
- • Extended in-home sessions (typically 30-60 min)
Best for: Seniors recovering from specific injuries, surgeries, or conditions that require clinical-level assessment and treatment planning. Often time-limited (6-12 sessions).
Typical cost: $80-$150/session (may be partially covered by OHIP or insurance)
How they work together
These roles aren't competing. They complement each other. A common care pathway: a physiotherapist assesses your parent after a fall or surgery and creates a treatment plan. An RST implements that plan with consistent, ongoing in-home exercise support. If and when your parent needs daily living assistance, a PSW provides hands-on personal care.
At Arcadia, we work closely with physiotherapists and other healthcare providers. And our sister service Arcadia Home Care provides PSW support, so families can access both rehabilitation and daily living support through connected services.
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Frequently Asked Questions
An RST (Rehabilitation Support Therapist) is a kinesiology-trained professional who provides in-home exercise programs for seniors. They focus on maintaining and rebuilding strength, balance, and independence through supervised exercise, including balance training, strength building, aquatherapy, and cognitive exercises. Think of them as a personal exercise partner for seniors.
If your parent needs to maintain or rebuild physical abilities (strength, balance, mobility, cooking), they need an RST. If they need hands-on help with daily tasks they can no longer do (bathing, dressing, eating), they need a PSW. Many families start with an RST and add PSW support later if needed, or use both simultaneously.
No. They serve different functions. A physiotherapist provides clinical assessment, diagnosis, and treatment planning (often post-injury or post-surgery). An RST provides ongoing exercise implementation, supervision, and support. They complement each other: a PT might design the initial plan, and an RST provides the consistent, long-term exercise support that makes the plan work.
RST services are typically private pay. Some extended health insurance plans may cover kinesiology services. Contact your insurance provider to check coverage. While RST is an out-of-pocket cost, it's significantly less expensive than the reactive care costs it helps prevent.