Geriatric Rehabilitation

Geriatric Rehabilitation

• Geriatric Rehabilitation (GR) aims to restore function or enhance residual functional capability, improving the quality of life in older people, particularly those with disabling impairments and/or frailty.

Principles of Geriatric Rehabilitation

• Rehabilitation should encompass psychosocial components of health and wellbeing.
• Principles of GR are essential in optimizing function, which is essential for effective therapeutic outcomes in older adults.
• Rehabilitation focuses on function and well-being, not exclusively on disease.

Importance of Geriatric Rehabilitation

• 11% of older patients are referred to rehabilitation facilities after hospitalization.
• The increasing geriatric population and apparent increases in disability will increase the need for rehabilitation.
• GR can assist in preserving functional independence and improving the quality of life.

Rehabilitation of Older Adults

• Emphasize functional activity to maintain functional mobility and capability.
• Improve balance through exercise and functional activity programs.
• Ensure good nutrition and general care.
• Provide social and emotional support.

Preventing Complications

• Prevent complications such as:
  • Aspiration
  • Anorexia
  • Inactivity
  • Bedsores
  • Constipation
  • Contractures
  • Cognition
  • DVTs
  • Depression
  • DFUs

Geriatric Physical Therapy Role

• Combating and minimizing the accumulative disabling effects of physical illness.
• Reducing institutionalization of patients.
• Providing education for patients and caregivers.
• Contributing to the comfort and well-being of patients.

Geriatric Physical Therapy Settings

• Inpatient medical rehabilitation
• Outpatient (primary care, private practice, etc.)
• Home health rehabilitation
• Long-term care
• Nursing-home rehabilitation

Common Geriatric Disorders for PT Cases

• Cardiovascular disorders: hypertension, CHD, heart failure
• Respiratory disorders: asthma, COPD
• Neurological and cognitive conditions: Stroke, Parkinson's disease, dementia, depression
• Musculoskeletal: osteoporosis, OA, RA, falls, fracture, incontinence
• Integumentary conditions: pressure ulcers, diabetic ulcers, venous stasis ulcers, herpes zoster, malignant tumors

Indications for Geriatric PT Referral

• Recent fall or history of falls
• Open wound
• Deficits in strength or range of motion
• Neurological disorder
• Balance deficits
• Loss of mobility or ambulation requiring an assistive device
• Musculoskeletal pain
• Difficulty with transfers
• Need for adaptive equipment to enhance safety and function
• Bed bound status

Challenges in Geriatric Rehabilitation

• Lack of specialized and trained manpower
• No dedicated health care infrastructure
• Geriatrics not yet a popular specialty