Geriatric Rehabilitation (Regabilitation in the Elderly)
GERIATRIC REHABILITATION (REHABILITATION IN THE ELDERLY)
What is geriatric rehabilitation?
Inevitably, some physiological changes occur in our body with aging. The addition of an extra discomfort on top of these changes makes elderly people more vulnerable than other age groups. All these disrupt the quality of life of the elderly person and cause a serious increase in general health expenses.
Preserving the quality of life of the elderly individual, who is a member of the society, and ensuring an active life is one of the common responsibilities of the whole society, especially the family, as well as the healthcare professionals. Geriatric rehabilitation is a concept that includes all efforts made to maximize the functional status of the elderly person in situations such as physical disability, illness and disability in the elderly. For this purpose, all of the services provided in order to prevent or minimize functional deterioration due to physiological and disease are examined under the umbrella of rehabilitation in the elderly.
Why is geriatric rehabilitation necessary?
Every person wants the deteriorated quality of life to return to the desired level. The main goal is to increase the life quality of the aging person in the most efficient and economical way. Geriatric rehabilitation is a necessity to achieve this goal. With some cheap and simple methods and treatments to be applied, both the life quality of the patient will be increased and the social economic burden will decrease.
How is geriatric rehabilitation implemented?
The principle that should not be forgotten in geriatric rehabilitation is that each patient has specific needs. For this reason, the fact that the rehabilitation program is personalized will increase the chance of success even more.
First of all, the functional evaluation of the patient should be done and the functional level should be determined. Then, the desired goals should be determined within the existing possibilities, taking into account the cognitive, cultural, social, familial, economic and physiological conditions of the person. The planned goals and the rehabilitation process should be shared with the relatives of the patients, and false expectations should not be entered into.
When to start geriatric rehabilitation?
Although there is no exact answer to the questions such as where, how long and when, researches have been going on for years in developed countries. Although the rehabilitation programs are tried to be achieved, the most important criteria for the selection of rehabilitation methods and goals are still the application practices and experiences of physicians.
The aim should be to choose the right patient, to use the resources efficiently and to benefit more patients from the services provided. Certain standards should be set, and a good geriatric evaluation should be made for this. Physical therapy and rehabilitation specialists should be involved in these evaluations. As general principles;
- The rehabilitation program should be started early,
- It should be multidisciplinary, that is, professionals from various branches should work together,
- The pace of the rehabilitation program should start at a slow pace, it should be simple,
- It should be tried to ensure the active participation of the patient in the rehabilitation program,
- There should be a patient-team relationship based on help and trust,
- The maximum possible mental and physical continuity in the patient should be targeted.
Where should geriatric rehabilitation be implemented?
It can be applied in major hospitals, rehabilitation centers, specialized nursing homes, retirement homes, clinics and home environment.
- Hospitals; It is the main headquarters, where the diagnostic tests and evaluations of the patients are usually carried out, as well as the short-term treatments, and the future planning of the patient after discharge. Here, it is decided in which environments the rehabilitation needs of the patient can be met for later.
- Rehabilitation centers; These are places that generally accommodate all healthcare professionals and where special rehabilitation programs are applied for the patient. Often they provide more intensive rehabilitation services than other units.
- Specialized nursing homes; They are boarding institutions that provide care and protection for elderly people in need of special care. They can contain many different properties.
- Nursing Homes; They are mostly places that provide services to elderly people in order to protect, care, and meet their social and psychological needs by creating a peaceful environment. It can be part time or full time.
- Hospital polyclinic services; Outpatient rehabilitation centers such as Rommer Physical Therapy and Rehabilitation Medical Center. All kinds of rehabilitation and exercise programs of the patient are planned and implemented. It is a very comfortable environment for the patient.
- Rehabilitation at home ; It includes some programs mostly accompanied by assistant health personnel such as therapists and nurses.
What should be done in geriatric rehabilitation?
Increasing functional capacity should be the main goal in physical activities performed in the elderly. Increasing this capacity will increase the quality of life. Our aim in exercises is to include all muscle groups in the activity, to have appropriate resting periods following short exercise periods and to be simple exercises that involve a lot of repetitions. The aims of the exercise applied in the elderly can be listed as;
- To integrate elderly people with other people, to create an environment for socializing,
- To improve the fitness of the elderly and to increase their physical capacity,
- To provide the necessary muscle strength to perform daily activities,
- To prevent falls by providing balance in the elderly.
The benefits of exercises for the elderly are strikingly positive.
- Sudden response time is shortened,
- Osteoporosis development decreases by making the bone mass heavier,
- Improved balance and posture,
- With the development of muscle mass, it reduces the risk of fracture,
- Increases joint flexibility, muscle strength and muscle resistance,
- It has positive effects on diseases such as obesity, diabetes, hypertension and hyperlipidemia.
Rehabilitation practices in the elderly should be realistic, repeated in a planned manner and changed when necessary. The individual should be helped to be independent and social by preserving existing functions and improving the quality of life for the rest of his life. The rehabilitation program should be specific to every elderly person in a way that positively affects the healing process of the person.
Future and expectations in geriatric rehabilitation
In the geriatric rehabilitation team, which includes different groups, there are physicians / physicians, physiotherapists, occupational therapists, speech therapists, psychologists, nurses, nutritionists, orthotics-prosthetics specialists, often under the leadership of a physical therapy and rehabilitation specialist.
Preventive medicine should always be at the forefront in the geriatric rehabilitation process. The needs of the elderly should be determined before they become needy and sick and the necessary measures should be taken. The responsibility should not be left only to the health personnel, this duty should be in the family members before the illness-addiction occurs.
Family members are natural members of the team. Therefore, family members should be informed and encouraged to take responsibility. Physical and mental overload on family members should be avoided, empathy should be shown to them. You should be alert to psychic problems such as depression etc. that may develop in family members.
In case the precautions are insufficient and / or an additional disease is added to the geriatric picture, it will be important to involve professional healthcare professionals.