Introduction: Maintaining a continuum of care is vital to ensure adequate health among older adults, particularly during periods of care transitions, when they are vulnerable and at risk of poor health outcomes. The Transition Care Program in Australia is designed to support older adults following the conclusion of a hospital episode. Using the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT), this study aimed to understand how the Transition Care Program impacts an older adult's occupational performance during care transitions. Methods: Data were collected as a part of usual occupational therapy care from March 2016 to August 2017 from clients admitted to a Gold Coast Health Transition Care Program. Data from 110 clients were analysed on 5 AusTOMs-OT scales: functional walking and mobility, upper limb use, self care, domestic life-home, and community life/recreation/leisure/play. Change data from these scales were analysed using the Wilcoxon Signed Ranks Test. Results: Clients in the Transition Care Program experienced statistically and clinically significant improvements in all AusTOMs-OT scales analysed as well as in each domain of impairment, activity limitation, participation restriction and distress/ wellbeing. Conclusion: These results are meaningful for clients, occupational therapists and Australian Transition Care Programs. Clients demonstrated progress towards their goals, indicating maintenance or improvements in their occupational performance, confirming for occupational therapists that the provision of services is promoting goal achievement and leading to improved occupational performance. The study also highlighted the benefits for the use of outcome measures such as the AusTOMs-OT to quantify and validate client change. K E Y W O R D S community participation, occupational therapy, outcome measure, patient-centred care, transition care How to cite this article: Smith HN, Fields SM. Changes in older adults' impairment, activity, participation and wellbeing as measured by the AusTOMs following participation in a Transition Care Program.