Abstract
Rehabilitation is a process of care directed at restoring or maintaining a person’s ability to live as independently as possible. It involves recovering from and adapting to the loss of physical, psychological, or social skills as a result of illness or trauma. Ultimately, those receiving rehabilitation hope to live in personally satisfying environments and maintain meaningful social relationships. In geriatrics, rehabilitation shifts from a goal of returning the patient to gainful employment to helping the older person live more independently. This type of care can be provided in any health care setting, including the home, office, acute or rehabilitation hospital, and long-term-care institution. An interdisciplinary team approach is required due to the complex nature of the various interventions. Patients and their families must be involved in decisions regarding rehabilitation treatment. Indeed, rehabilitation is a philosophical approach to the patient that recognizes that diagnoses are poor predictors of functional abilities, that having a disability does not diminish one’s social worth, and that the psychosocial aspects of care are at least as important as the medical aspects of care. Rehabilitation is an essential component of quality geriatric care that should be available to all those who might benefit.1 Recently, the American Geriatrics Society has recognized the importance of rehabilitation in its Public Policy Position statement (Table 17.1).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
AGS Public Policy Committee. Geriatric rehabilitation. J Am Geriatr Soc. 1990; 38: 10–49.
Anttila S. Functional capacity in two elderly populations aged 75 or over: comparisons at 10 years’ interval. J Clin Epidemiol 1991; 44: 1181–1186.
Manton KG, Corder L, Stallard E. Changes in the use of personal assistance and special equipment from 1982 to 1989: results from the 1982 and 1989 National Long Term Care Surveys. Gerontologist. 1993; 33: 168–176.
Manton KG, Stallard E, Singer BH. Projecting the future size and health status of the U.S. elderly population. In: Wise D, ed. The Economics of Aging. Chicago: National Bureau of Economic Research, University of Chicago Press. 1992.
Wedgewood J. The place of rehabilitation in geriatric medicine: an overview. Int Rehabil Med. 1985; 7: 107–108.
Lorish TR. Stroke rehabilitation. Clin Geriatr Med. 1993; 4: 705–716.
Mehta AJ, Nastasi AE. Rehabilitation of fractures in the elderly. Clin Geriatr Med. 1993; 4: 717–730.
Esquenazi A, Vachranukunkeit T, Torres M, et al. Characteristics of a current lower extremity amputee population: review of 918 cases. Arch Phys Med Rehabil. 1984; 65: 623.
Rubenstein LZ, Josephson KR, et al. Effectiveness of a geriatric evaluation unit: a randomized trial. N Engl J Med. 1984; 31: 1664–1670.
Wray LA, Torres-Gil FM. Availability of rehabilitation services for elders: a study of critical policy and financing issues. Generations. 1992;Winter:31–36.
Siebens H. Deconditioning. In: Kemp B, Brummel-Smith K, Ramsdell JW, eds. Geriatric Rehabilitation. Austin, TX: Pro-Ed; 1990: 183.
Avorn J. Induced disability in nursing home patients. J Am Geriatr Soc. 1980; 30: 397–400.
Brody E. Informal support systems in the rehabilitation of the disabled elderly. In: Brody SJ, Ruff GE, eds. Aging and Rehabilitation. New York: Springer; 1986.
Youngblood NM, Hines J. The influence of the family’s perception of disability on rehabilitation outcomes. Rehabil Nurs. 1992; 17: 323–326.
Gregor S, McCarthy K, Chwirchak D, et al. Characteristics and functional outcomes of elderly rehabilitation patients. Rehabil Nurs. 1986; 11: 10–14.
Lillie SM. Evaluation for driving. In: Yoshikawa TT, Cobbs EL, Brummel-Smith K, eds. Ambulatory Geriatric Medicine. St. Louis: Mosby; 1993: 131–141.
Hamberger SG, Tanner RD. Nursing interventions with families of geriatric patients. Top Geriatr Rehabil. 1988; 4: 32–39.
Bozarth JD. The rehabilitation process and older people. J Rehabil. 1981; 47: 28–32.
Wright B. Physical Disability: A Psychosocial Approach. 2nd ed. New York: Harper and Row; 1983.
Portnow J, Kline T, Daly MA, et al. Multidisciplinary home rehabilitation: a practical model. Clin Geriatr Med. 1991; 7: 695–706.
Jarnlo GB, Ceder L, Thorngren KG. Early rehabilitation at home of elderly patients with hip fractures and consumption of resources in primary care. ScandJ Prim Health Care. 1984; 2: 105–112.
Liang MH, Partridge AJ, Larson MG, et al. Evaluation of comprehensive rehabilitation services for elderly home-bound patients with arthritis and orthopedic disability. Athritis Rheum. 1984; 27: 258–266.
Miller NH, Haskell WL, Berra K, DeBusk RF. Home versus group exercise training for increasing functional capacity after myocardial infarction. Circulation. 1984; 70: 645–649.
Liang MH, et al. Evaluation of comprehensive rehabilitation services for elderly homebound patients with arthritis and orthopedic disability. Arthritis Rheum. 1984; 27: 258–266.
Steel K, Gettmon PM, Crescenzi C, et al. Iatrogenic illness on a general medical service at a university hospital. N Engl J Med. 1981; 304: 638–642.
Gorbien MJ, Bishop J, Beers MH, et al. Iatrogenic illness in hospitalized elderly people. J Am Geriatr Soc. 1992; 40: 1031–1042.
Warshaw G, Moore JT, Friedman W, et al. Functional disability in the hospitalized elderly. JAMA. 1982; 248: 847–850.
Evans RL, Haselkorn JK, Bishop DS, Hendricks RD. Characteristics of hospital patients receiving rehabilitation: an exploratory outcome comparison. Arch Phys Med Rehabil. 1991; 72: 685–689.
Applegate WB, Miller ST, Graney MJ, et al. A randomized, controlled trial of a geriatric assessment unit in a community rehabilitation hospital. N Engl J Med. 1990; 322: 1572–1578.
Sainsbury R, et al. An orthopedic geriatric rehabilitation unit: the first two years experience. NZ Med J. 1986; 99: 583–585.
Cameron ID. Accelerated rehabilitation after hip fracture: a randomized controlled trial. Disabil Rehabil. 1993; 15: 29–34.
Kenny DC. Effectiveness of geriatric rehabilitation after hip fracture. Br Med J. 1988; 297: 1083–1086.
Langhorne P, Williams BO, Gilchrist W, Howie K. Do stroke units reduce mortality? Lancet. 1993; 342: 395–398.
Liem PH, Chernoff R, Carter WJ. Geriatric rehabilitation unit: a 3-year outcome. J Gerontol 1986; 41: 44–50.
Rondinelli DRD, Murphy JR, Wilson DH, Miller CC. Predictors of functional outcome and resource utilization in inpatient rehabilitation. Arch Phys Med Rehabil 1991; 72: 447–453.
Joseph CL, Wanlass W. Rehabilitation in the nursing home. Clin Geriatr Med. 1993; 4: 859–871.
Adelman RD, et al. A community oriented geriatric rehabilitation unit in a nursing home. Gerontologist. 1987; 27: 143–146.
Mulrow CD, Gerety MB, Kanten D, et al. A randomized trial of physical rehabilitation of very frail nursing home residents. JAMA. 1994; 271: 519–524.
Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994; 330: 1769–1775.
Gishert NM, Pendergast DR, Calkins E. Muscle rehabilitation in impaired elderly nursing home residents. Arch Phys Med Rehabil 1991; 72: 181–185.
Mosqueda LA. Assessment of rehabilitation potential. Clin Geriatr Med. 1993; 4: 689–703.
Mahoney F, Barthel D. Functional evaluation: Barthel Index. Maryland State Med J. 1965; 14: 61–65.
Granger C, Hamilton B, Keith R, et al. Advances in functional assessment for medical rehabilitation. Topics Geriatr Rehabil 1986; 3: 59–74.
Lehman JF, Wieland GD. Stroke: does rehabilitation affect outcome? Arch Phys Med Rehabil 1975; 56: 375–382.
Ottenbacher KJ, Jannell S. The results of clinical trials in stroke rehabilitation research. Arch Neurol 1993; 50: 37–44.
Falconer JA, Naughton BJ, Strasser DC, Sinacore JM. Stroke inpatient rehabilitation: a comparison across age groups./Am Geriatr Soc. 1994; 42: 39–44.
Braus DF, Krauss JK, Strobel J. The shoulder-hand syndrome after stroke: a prospective clinical trial. Ann Neurol 1994; 36: 728–733.
Dombovy M, Sandok B, Basford J. Rehabilitation for stroke: a review. Stroke. 1986; 8: 651–656.
Evans RL, Bishop DS, Haselkorn JK. Factors predicting satisfactory home care after a stroke. Arch Phys Med Rehabil. 1991; 72: 144–147.
Morris PL, Raphael B, Robinson RG. Clinical depression is associated with impaired recovery from stroke. MedJAust. 1992; 157: 239–242.
Lazarus LW, Winemiller DR, Lingam VR, et al. Efficacy and side effects of methylphenidate for poststroke depression. J Clin Psychiatry. 1992; 53: 447–449.
Martin BJ, Corlew MM. The incidence of communication disorders in dysphagic patients. J Speech Hear Disord. 1990; 55: 28–32.
Wade DT, Collen FM, Robb GF, Warlow CP. Physiotherapy intervention after stroke and mobility. Br Med J. 1992; 304: 609–613.
Tangemen PT, Banaitis DA, Williams AK. Rehabilitation of chronic stroke patients: changes in functional performance. Arch Phys Med Rehabil. 1990; 71: 876–880.
Bentur N, Eldar R. Quality of rehabilitation care in two inpatient geriatric settings. Qual Assur Health Care. 1993; 3: 237–242.
Hollingworth W, Todd C, Parker M, et al. Cost analysis of early discharge after hip fracture. Br Med J. 1993; 307: 903–906.
Bonar SK, Tinetti ME, Speechley M, Cooney LM. Factors associated with short-versus long-term skilled nursing facility placement among community-living hip fracture patients. J Am Geriatr Soc. 1990; 38: 1139–1144.
Mahoney J, Euhardy R, Carnes M. A comparison of a two-wheeled walker and a three-wheeled walker in a geriatric population./Am Geriatr Soc. 1992; 40: 208–212.
Malone JM. Complications of lower extremity amputation. In: Moore WS, Malone JM, eds. Lower Extremity Amputation. Philadelphia: WB Saunders; 1989: 208.
Campbell WB, St. Johnston JA, Kernick VF, Rutter EA. Lower limb amputation: striking the balance. Ann R Coll Surg Engl. 1994; 76: 205–209.
van den Broek TA, Dwars BJ, Rauwerda JA, Bakker FC. A multivariate analysis of determinants of wound healing in patients after amputation for peripheral vascular disease. Eur J Vase Surg. 1990; 4: 291–295.
Clark GS, Blue B, Bearer JB. Rehabilitation of the elderly amputee./Am Geriatr Soc. 1983; 31: 439–448.
Casillas JM, Michel C, Aurelle B, Becker F, et al. Transcutaneous oxygen pressure. An effective measure for prosthesis fitting on below-knee amputations. Am J Phys Med Rehabil. 1993; 72: 29–32.
Davidoff GN, Lampman RM, Westbury L, et al. Exercise testing and training of persons with dysvascular amputation: safety and efficacy of arm ergometry. Arch Phys Med Rehabil. 1992; 73: 334–338.
MacLean N, Fick GH. The effect of semirigid dressings on below-knee amputations. Phys Ther. 1994; 74: 668–673.
Folsom D, King T, Rubin JR. Lower-extremity amputation with immediate postoperative prosthetic placement. Am J Surg. 1992; 164: 320–322.
Brodzka WK, Thornhill HL, Zarapkar SE, et al. Long-term function of persons with atherosclerotic bilateral below-knee amputation living in the inner city. Arch Phys Med Rehabil. 1990; 71: 895–900.
Formisano R, Pratesi L, Modarelli FT, et al. Rehabilitation and Parkinson’s disease. Scand J Rehab Med. 1992; 24: 157–160.
Mutch WJ, Strudwick A, Roy SK, Downie AW. Parkinson’s disease: disability, review and management. Br Med J. 1986; 293: 675–677.
Johnson JA, Pring TR. Speech therapy and Parkinson’s disease: a review and further data. Br J Disord Commun. 1990; 25: 183–194.
Vorhies D, Riley BE. Deconditioning. Clin Geriatr Med. 1993; 9: 745–763.
Hamdorf PA, Withers RT, Penhall RK, Haslam MV. Physical training effects on the fitness and habitual activity patterns of elderly women. Arch Phys Med Rehabil. 1992; 73: 603–608.
Kovar PA, Allegrante JP, MacKenzie R, et al. Supervised fitness walking in patients with osteoarthritis of the knee. Ann Intern Med. 1992; 116: 529–534.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1997 Springer Science+Business Media New York
About this chapter
Cite this chapter
Brummel-Smith, K. (1997). Rehabilitation. In: Cassel, C.K., et al. Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2705-0_17
Download citation
DOI: https://doi.org/10.1007/978-1-4757-2705-0_17
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4757-2707-4
Online ISBN: 978-1-4757-2705-0
eBook Packages: Springer Book Archive