1. The document discusses healthy aging and maintaining functional ability in older adults through rehabilitation. It focuses on promoting independence and preventing issues like falls, immobility, and disability.
2. Functional ability depends on basic needs, mobility, relationships, decision-making, and contributing to society. Assessing for risk factors and implementing medical, lifestyle and environmental interventions can support healthy aging.
3. Rehabilitation aims to optimize physical and cognitive function so that elderly adults can safely perform daily activities and live independently for as long as possible.
2. “AS MODERN MEDICINE ADDS
YEARS TO LIFE,REHABILITATION
BECOMES INCREASINGLY
NECESSARY TO ADD LIFE TO THOSE
YEARS”
-RUSK
3.
4. “Healthy aging is the process of developing and
maintaining the functional ability that
enables wellbeing in older age”.
Functional ability is about having the capabilities that
enable all people to be and do what they have reason to value.
This includes a person’s ability to:
meet their basic needs;
learn, grow and make decisions;
be mobile;
build and maintain relationships;
contribute to society.
5.
6.
7. The elderly are not a homogenous group
According to the WHO,
>=65 yrs is accepted as definition of ‘older
or Elderly ‘ persons
According to the UN,
60+ age is considered as older population
or elderly
65 to 75 - YOUNG OLD
75 to 85 - OLD OLD
>85 - VERY OLD
20% of population >65 by 2025
8.
9. Vulnerability to stressors
Need to treat underlying conditions
Minimize risk for falls, disability, hospitilaztion,& mortality
Primary &secondary prevention
15. Sarcopenia – decreased muscle mass
& strength
Osteopenia & Osteoporosis –
decreased bone strength
Osteoarthritis – degenerative changes
in joints
In muscle fibro-connective tissue build
up and fat accumulation affects its
quality& function
16. Increased stride to stride variability in length
Increased stride to stride variability in speed
Increased time of double-support phase
17. 1/3 of elderly have a history of falls
20% result in injury (5% end in fracture)
Risk factors of falls include
Poor muscle strength ,
Neural damage on basal ganglia and cerebellum
Diabetes & Peripheral neuropathy
Interventions to prevent or reduce instability &
falls include
Medical
Rehabilitative
Environmental modification approach
20. Greater challenges than the young amputee
Less reserve in many systems
Pre-amputation deconditioning
Contractures
Congestive Cardiac Failure
COPD
21. History
Physical Examination
Functional assessment
Family
Social support
Environment & Architectural Problems
Economic problems
22. I Inflammation of joints (or joint deformity)
H Hypotension (orthostatic blood pressure changes)
A Auditory and visual abnormalities
T Tremor (Parkinson's disease or other causes of
tremor)
E Equilibrium (balance) problem
F Foot problems
A Arrhythmia, heart block or valvular disease
L Leg-length discrepancy
L Lack of conditioning (generalized weakness)
I Illness
N Nutrition (poor; weight loss)
G Gait disturbance
23. Activities of Daily Living (ADL)
Instrumental Activities of Daily Living (IADLS)
Functional Independence Measure Scale(FIMS)
Barthel Index
Mobility questionnaire
Short Physical performance battery
Berg balance scale
Walking speed
6-minute walk
Long distance corridor walk
24. Pharmacological
Lifestyle modifications
Dietary & Nutritional support
Rehabilitation interventions
Prevention of falls
25. Highest priority for most elderly people for a
satisfying Quality Of Life(QOL) is to
MAINTAIN INDEPENDENCE
26. Functional assessment
Realistic goal setting
Interdisciplinary Team care
Efficacious Adjustment of Therapy interventions
27. 1.Stabilization of primary problem
2.Prevent secondary complications
3.Restore lost function
4.Adaptation of person to new disability
5.Adaptation of the living facility
6.Working with family
28. Medical assessment
Assessment of nursing needs
Assessment of impairments
Assessment of disabilities
Assessment of cognitive function
Assessment of the patient’s strengths / resources
Assessment of the patient’s and family’s priorities
32. Significant gains in muscle strength as well as functional
mobility have been demonstrated in older indivuials
with a structured high intensity program
Increase muscle strength, endurance and maximal
aerobic capacity
Increase flexibility, coordination and balance
Reduce risk for falling & enhance mobility
Promote socialization & self-esteem
Helps in maintaining or promoting independence in
ADLs
33. FLOOR :
use nonslip tiles in Bathrooms
use nonslip adhesive strips on floor
next to tub, sink and toilet
carpeting (low pile & border)
Lighting :
lighting in high-risk areas eg.stairs, bathroom,
bedroom
Floor glare by reposition of light source
34. Stairs :
Place light switches at top and bottom of stairway,
Apply coloured non-skid adhesive strips to stair edges,
Set maximum step rise at 6 inches
Handrails :
Place cylindrical rails 1-2 in away from wall on both
sides
35. Bed Height:
Bed ht. from patella to floor (18 in. from top of mattress
to floor)
Chair Height:
14- 16 in. from seat edge to floor armrests ~ 7 in above
the seat and extend 1-2 in beyond the seat edge
Shelf Height:
Rearrange frequently used items to avoid excessive
reaching and bending
36. Toilet seat :
Use of elevated toilet with grab bars placed on wall
next to the toilet
Shower floor surfaces :
Use of shower chair and flexible hand-held shower
Health faucet for ablutions
37. Avoid serious, debilitating diseases and
disability.
Engage independently in most normal
activities of daily living.
Maintain cognitive function.
Able to cope with physical, social, and
emotional changes
Editor's Notes
Functional ability is made up of the intrinsic capacity of the individual, relevant environmental characteristics and the interaction between them It may be defined as “evaluative, diagnostic, and therapeutic interventions whose purpose is to restore functional ability or enhance residual functional capability in elderly people with disabling impairments
Frailty can be defined as age- and disease-related loss of adaptation, such that events of previously minor stress result in disproportionate biomedical and social consequences
like weakness, under-nutrition
Post-menopausal age most vulnerable
A ‘silent disease’ till a # occursHip, vertebral, distal radial & humeral neck fractures most common sequele
All except Hip fractures treated conservatively
Common in geriatric population
Primary generalised OA –affects hands with formation of Heberden’s & Bouchard’s Nodes
Mostly affects the knees, hips and spine
Pain, deformity and decreased mobility