Geriatric rehabilitation
Geriatric rehabilitation is called a specialized rehabilitation for older patients that takes multimorbidity into account. The aim of geriatric rehabilitation is to restore individual independence and avoid the need for care after a serious illness.
After a standardized geriatric assessment has been carried out, rehabilitation is carried out by a geriatric team. In the course of the rehabilitation measure and before discharge, the assessments are repeated, thus allowing precise progress and success control. The progress made can be described very precisely in this way. Rehabilitation is particularly useful after a stroke or after a fall. The average age of the patients in geriatric rehabilitation is around 80 years and, in addition to the main disease, there are on average around five other diagnoses that require treatment.
The selection of geriatric patients is becoming ever more stringent. The number of cases in which geriatric patients continue to receive treatment at a lower daily rate in so-called specialist rehabilitation clinics (such as orthopedic rehab) is increasing. The financing of geriatric rehabilitation is also problematic: statutory health insurance bears the costs of rehabilitation, while long-term care insurance benefits from successful rehabilitation through lower follow-up costs when the level of care and thus the care allowance falls.
Therapeutic approach
In geriatric rehabilitation, patients are cared for by a therapeutic team consisting of doctors, nurses, physiotherapists, sports therapists, occupational therapists, speech therapists, masseurs and med. There is pool attendants, social workers, psychologists and nutritionists.
This geriatric team uses a so-called geriatric assessment to determine which disabilities and problems exist and what rehabilitation potential is available for the individual patient. The individual rehabilitation goal is then set for each patient in the team and regularly checked in joint team meetings during the rehabilitation. During the treatment, the patients are provided with individually adapted remedies and aids as required. In a home visit z. B. by occupational therapists and social workers, if necessary, will check whether a living space adaptation is necessary to make a return to a safe home environment possible. During the rehabilitation, relatives are included if possible so that they can deal with the disabilities and any necessary aids such as B. learn a wheelchair under the guidance of the team. Discharge planning is an important phase of geriatric rehabilitation in order to provide the patient with a social network that guarantees medical, nursing and domestic care for the patient at home. The treatment period is on average three to four weeks inpatient in a geriatric rehabilitation clinic that is as close as possible to home. Recently, however, more and more so-called “rehabilitation attempts” over a period of around 10 days have been approved. In the opinion of the health insurers, an extension can be made if successful within this period (represented for example by an improvement in the Barthel index ). A current publication in the Journal of Clinical Rehabilitation shows that this procedure might have to be reversed . There it was shown that the patients with less success within the first week benefit more from an extension than those with greater success. Rehabilitation can also take place on a day-care basis in a day clinic, in an outpatient geriatric facility or as mobile geriatric rehabilitation in the patient's home environment.
Individual evidence
- ↑ (Clinical Rehabilitation, May 2010; vol. 24, 5: pp. 463-470)
- ↑ What is mobile rehabilitation? Federal Working Group Mobile Rehabilitation eV, accessed on August 24, 2019