Welcome to the Geriatric review Module.
Disability is generally regarded as being due to a pathological process, or injury, not necessarily from old age’. The effects of biological ageing reduce the efficiency of the body’s systems. Optimum function is maintained in each individual by continuing to use the body’s systems to their maximum capacity. Physiotherapists have a key role in enabling older people to use a number of the body’s systems more optimally to enhance mobility and independence. The objective of the physical therapist is to improve the patient’s quality of life by maintaining or increasing the patient’s independence, safety and well being. This is achieved through thorough assessment of the geriatric patient’s physical abilities, maximizing joint and muscle mobility, optimizing strength, prevention of inactivity and falls, improving functional activity and decreasing limitations in activities. Treatment goals and successive interventions can be determined based on the assessment and the patient’s desired goals.
When improvement or maintenance of functional mobility is no longer a reasonable goal, physiotherapists can contribute to helping older people to remain comfortable and pain free. Physiotherapists can also play a role in the prevention of the development of problems in later life through health promotion.
Older adults may have co-morbidities that need to be identified and addressed. The medical / surgical history and supporting drug history is of significant importance as an older person can often be put on medication and left with no review until toxic levels have been reached. The individual might not report a medical condition to you that they are taking medication for if it is unrelated to the reason why they have attended to physiotherapy. A detailed medication and general health history must be done. It is advised that this be done at intake as well as through subjective examination by the physiotherapist. Older adults may have multiple areas or systems of involvement that all effect the overall presentation. All may need to be addressed in treatment.
Many of the conditions that effect the geriatric population have been covered in the musculoskeletal, neurologic and cardiopulmonary review sections of the EPE guide.
- Reduce pain
- Improve mobility
- Improve sensation, joint proprioception
- Increase overall fitness through exercise programs
- Suggest assistive devices to promote independence
- Recommend adaptations to make the person’s home accessible and safe
- Prevent further decline in functional abilities through education, energy conservation techniques, joint protection
- Increase, restore or maintain range of motion, physical strength, flexibility, coordination, balance and endurance
- Teach positioning, transfers, and walking skills to promote maximum function and independence within the person’s capability