Geriatric Rehabilitation

When frail older persons are confronted with an acute decline in function, for instance because of a fracture after a fall, paralysis after a stroke, or functional decline after a severe infection, recovery is by no means self-evident. The goal of geriatric rehabilitation is to restore functional capacity and participation in these patients. In this chapter, specific aspects of the typical geriatric rehabilitation patient, such as association with other geriatric syndromes, are described. Frailty, sarcopenia, comorbidity, and polypharmacy are all potential modifiers of the recovery process of frail older persons after an acute decline in function, and should therefore be managed. The process of post-acute care assessment is based on comprehensive geriatric assessment and assessment of functional prognosis, which requires an interdisciplinary approach. In addition to a physician with geriatrics and rehabilitation training, physiotherapists, nurses, occupational therapists, psychologists, speech therapists, dieticians, and social workers can complete the team. Different professionals provide therapy based on the individual patient’s needs using a variety of instruments to monitor the outcomes. Individual goal assessment and integrated care pathways are part of the geriatric rehabilitation planning process. Next to mobility and ADLs, nutritional status and psychological needs are also addressed in the rehabilitation plan, and more participatory goals such as doing groceries are outcomes that are typical to geriatric rehabilitation. The rehabilitation plan is made and evaluated in multidisciplinary team meetings. Participation of the client and the informal care givers in the process leads to better outcomes.