Rehabilitation

Assessment begins with establishing the patient’s suitability for a rehabilitation program. In order to benefit from a geriatric rehabilitation program, the patient must be medically stable and have a minimum of endurance to undergo at least an hour per day of therapy. Patients must be motivated to participate actively in the program, and must have sufficient cognitive function to be able to learn simple tasks with repetition. They must require the expertise of at least two different rehabilitation disciplines.

The World Health Organization has defined several terms to facilitate communication. These include impairments, which are problems in body function or structure (e.g., an arthritic joint or a stroke). Activity limitations are difficulties an individual has in performance of activities (e.g., being unable to walk safely on stairs). Participation restrictions are problems an individual may have concerning involvement in life situations (e.g., being housebound because the only access requires using stairs, and there is no ramp or elevator in place). The rehabilitation team addresses activity limitations and participation restrictions associated with specific impairments.

It is important to get a good picture of the patient’s weaknesses and strengths in the spheres of mobility, self-care (bathing, dressing), continence, cognition, mood, and social situation. There are many different outcome measurements that are used to record and follow level of function. It is important to be aware of the patient’s previous level of function in order to set appropriate goals. Priority is given to the goals of the patient and family members.