What Are Fluctuating Conditions?

A fluctuating condition is one where symptoms:

• Vary day-to-day or week-to-week
• Can worsen suddenly (flare-ups)
• May improve temporarily before declining again

This unpredictability makes it difficult to rely on rigid support structures.

The Challenge Within the NDIS System

The NDIS is designed around “reasonable and necessary” supports, often based on an assessment at a specific point in time.

But what happens when:

• Your condition worsens?
• Your capacity decreases temporarily?
• You need more support some weeks than others?

Participants can find themselves:

• Under-supported during flare-ups
• Overwhelmed trying to manage changes
• Unsure how to adjust their plan

Why Flexibility Is So Important

For fluctuating conditions, flexibility isn’t a luxury, it’s essential.

Effective supports may include:

• Adjustable support worker hours
• A mix of in-home and community supports
• Access to assistive technology
• Allied health supports that can scale up or down

The goal is to create a system that responds to the participant, not the other way around.

The Role of Support Coordination

Support coordination plays a key role in managing this complexity.

At A1 Coordination, we help participants:

• Monitor how their needs are changing over time
• Adjust services within their existing plan where possible
• Prepare for plan reviews with accurate, real-world evidence
• Advocate for increased supports when needed

We also help participants avoid gaps in care, especially during periods of increased need.

Planning for the “Bad Days”

One of the most important strategies is planning for fluctuations in advance.

This might include:

• Building in flexible funding where possible
• Identifying backup providers
• Creating clear communication plans with support teams
• Documenting patterns of flare-ups or symptom changes

This kind of proactive planning can reduce stress and improve outcomes.

When to Request a Plan Review

Sometimes, changes in condition mean the current plan is no longer appropriate.

You may need a plan review if:

• Your condition has significantly worsened
• You’re consistently running out of supports
• Your current services are no longer meeting your needs

Support coordinators can guide you through this process and help gather the right evidence.

Living with a fluctuating condition can be exhausting, not just physically, but mentally and emotionally.

The NDIS can support these conditions, but only when plans are used flexibly and reviewed when needed.

Awareness days like World Multiple Sclerosis Day and International ME/CFS Awareness Day highlight the importance of recognising that capacity isn’t fixed, and supports shouldn’t be either.