Nurse assistant has as first-line caregivers in care of older people, a unique opportunity to encourage physical activity and exercise in older people. Hence,the staff’s perceptions about physical activity and exercise among older persons are essential. The aim of this study was to describe how nurse assistants in their work perceived physical activity and exercise for older people over 65 receiving home care and home help services. Method: Data were collected through interviews with 19 nurse assistants selected by strategic sampling and analysed using a phenomenographic approach. Results: The findings show two different perceptions of physical activity: “physical activity is to move “as everyday movements that older people did in activities of daily living andoutdoors activities and “physical activity is to make an effort” which older people makes handling their daily living and outdoors activities or struggling to be less inactive with healthy activities. Three differen tperceptions of exercise emerged: “exercise as physical activity” as movements that could be done either through an individual exercise programs from physiotherapist or by activities of daily life such as dressing, cleaning or shopping; “exercise as rehabilitation” as part of the rehabilitation processor as a prescription to follow and “exercise as an agent” enhancing health and well being of older people principally related to the mobility or enhancing older people’s social activities. Conclusion: By describing nurse assistants perceptions of physical activity and exercise among older people, this study provides information about two different approaches used by nurse assistants inhome help services. Nurse assistants have two different approaches towards the older person: a health promoting approach and a preventive approach. An educational awareness about the different approaches could enable staff to engage and support the older person to be physically active and to exercise regularly. A supportive organisation with flexibility and a closely collaboration between social services and health professionals could facilitate and strengthening a health promoting and a preventive approach by nurse assistant.