Skip to main content
SpringerLink
Log in

Geriatric Rehabilitation

  • Reference work entry
  • First Online:
Geriatric Medicine

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Cosin LZ. Geriatric rehabilitation. Lancet. 1947;2(6483):804.

    Article  CAS  PubMed  Google Scholar 

  2. Asher RAJ. The dangers of going to bed. BMJ. 1947;2:967–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Achterberg WP, Cameron ID, Bauer JM, Schols JM. Geriatric rehabilitation-state of the art and future priorities. J Am Med Dir Assoc. 2019;20(4):396–8.

    Article  PubMed  Google Scholar 

  4. Grund S, Gordon AL, van Balen R, et al. European consensus on core principles and future priorities for geriatric rehabilitation: consensus statement. Eur Geriatr Med. 2020;11(2):233–8.

    Article  PubMed  Google Scholar 

  5. Gladman JR. The international classification of functioning, disability and health and its value to rehabilitation and geriatric medicine. J Chin Med Assoc. 2008;71(6):275–8.

    Article  PubMed  Google Scholar 

  6. Kabboord AD, van Eijk M, Fiocco M, van Balen R, Achterberg WP. Assessment of comorbidity burden and its association with functional rehabilitation outcome after stroke or hip fracture: a systematic review and meta-analysis. J Am Med Dir Assoc. 2016;17(11):1066.e13–21.

    Article  PubMed  Google Scholar 

  7. Campbell N, Boustani M, Limbil T, et al. The cognitive impact of anticholinergics: a clinical review. Clin Interv Aging. 2009;4:225–33.

    PubMed  PubMed Central  Google Scholar 

  8. Fox C, Smith T, Maidment I, et al. Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality: a systematic review. Age Ageing. 2014;43(5):604–15.

    Article  PubMed  Google Scholar 

  9. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis (published correction appears in age ageing. 2019 Jul 1;48(4):601). Age Ageing. 2019;48(1):16–31.

    Article  PubMed  Google Scholar 

  10. Bernabei R, Martone AM, Vetrano DL, Calvani R, Landi F, Marzetti E. Frailty, physical frailty, sarcopenia: a new conceptual model. Stud Health Technol Inform. 2014;203:78–84.

    PubMed  Google Scholar 

  11. Buchner DM, Wagner EH. Preventing frail health. Clin Geriatr Med. 1992;8(1):1–17.

    Article  CAS  PubMed  Google Scholar 

  12. Zisberg A, Shadmi E, Gur-Yaish N, Tonkikh O, Sinoff G. Hospital-associated functional decline: the role of hospitalization processes beyond individual risk factors. J Am Geriatr Soc. 2015;63(1):55–62.

    Article  PubMed  Google Scholar 

  13. Blomaard LC, Mooijaart SP, Bolt S, et al. Feasibility and acceptability of the ‘Acutely presenting older Patient’ screener in routine emergency department care (published online ahead of print, 2020 may 18). Age Ageing. 2020;49(6):1034–41.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Cuevas-Trisan R. Balance problems and fall risks in the elderly. Clin Geriatr Med. 2019;35(2):173–83.

    Article  PubMed  Google Scholar 

  15. Kool J, Oesch P, Bachmann S. Predictors for living at home after geriatric inpatient rehabilitation: A prospective cohort study. J Rehabil Med. 2017;49(2):185–90.

    Article  PubMed  Google Scholar 

  16. Smit EB, Bouwstra H, van der Wouden JC, Wattel LM, Hertogh CMPM. Patient-centred goal setting using functional outcome measures in geriatric rehabilitation: is it feasible? Eur Geriatr Med. 2018;9(1):71–6.

    Article  PubMed  Google Scholar 

  17. Levack WM, Weatherall M, Hay-Smith EJ, Dean SG, McPherson K, Siegert RJ. Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation. Cochrane Database Syst Rev. 2015;2015(7):CD009727.

    PubMed  PubMed Central  Google Scholar 

  18. van Seben R, Smorenburg SM, Buurman BM. A qualitative study of patient-centered goal-setting in geriatric rehabilitation: patient and professional perspectives. Clin Rehabil. 2019;33(1):128–40.

    Article  PubMed  Google Scholar 

  19. Dörfler E, Kulnik ST. Despite communication and cognitive impairment – person-centred goal-setting after stroke: a qualitative study (published online ahead of print, 2019 Apr 25). Disabil Rehabil. 2019;42(25):1–10.

    Google Scholar 

  20. Rosewilliam S, Roskell CA, Pandyan AD. A systematic review and synthesis of the quantitative and qualitative evidence behind patient-centred goal setting in stroke rehabilitation. Clin Rehabil. 2011;25(6):501–14.

    Article  PubMed  Google Scholar 

  21. Rose A, Rosewilliam S, Soundy A. Shared decision making within goal setting in rehabilitation settings: a systematic review. Patient Educ Couns. 2017;100(1):65–75.

    Article  PubMed  Google Scholar 

  22. van Balen R, Gordon AL, Schols JMGA, et al. What is geriatric rehabilitation and how should it be organized? A Delphi study aimed at reaching European consensus. Eur Geriatr Med. 2019;10(6):977–87.

    Article  PubMed  Google Scholar 

  23. Holstege MS, Bakkers E, van Balen R, Gussekloo J, Achterberg WP, Caljouw MA. Structured scoring of supporting nursing tasks to enhance early discharge in geriatric rehabilitation: the BACK-HOME quasi-experimental study. Int J Nurs Stud. 2016;64:13–8.

    Article  CAS  PubMed  Google Scholar 

  24. Tijsen LM, Derksen EW, Achterberg WP, Buijck BI. Challenging rehabilitation environment for older patients. Clin Interv Aging. 2019;14:1451–60.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Holstege MS, Caljouw MAA, Zekveld IG, et al. Successful geriatric rehabilitation: effects on patients’ outcome of a national program to improve quality of care, the SINGER study. J Am Med Dir Assoc. 2017;18(5):383–7.

    Article  PubMed  Google Scholar 

  26. Smit EB, Bouwstra H, van der Wouden JC, et al. Development of a patient-reported outcomes measurement information system (PROMIS®) short form for measuring physical function in geriatric rehabilitation patients (published online ahead of print, 2020 Apr 21). Qual Life Res. 2020;29(9):2563–72. https://doi.org/10.1007/s11136-020-02506-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Kabboord AD, van Eijk M, van Dingenen L, et al. Reliability and usability of a weighted version of the Functional Comorbidity Index. Clin Interv Aging. 2019;14:289–99.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Vanhaecht K, Panella M, van Zelm R, Sermeus W. What about care pathways? In: Ellershaw J, Wilkinson S, editors. Care of the dying: a pathway to excellence. Oxford: Oxford University Press; 2010.

    Google Scholar 

  29. Huttin C. The use of clinical guidelines to improve medical practice: main issues in the United States. J Int Soc Q Health Care. 1997;9:207–14.

    Article  CAS  Google Scholar 

  30. Everink IHJ, van Haastregt JCM, Tan FES, Schols JMGA, Kempen GIJM. The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study. BMC Geriatr. 2018;18(1):285.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ouellet JA, Cooney LM Jr. Hip fracture: can we do better? J Am Geriatr Soc. 2017;65(1):22–4.

    Article  PubMed  Google Scholar 

  32. Smith TO, Hameed YA, Cross JL, Henderson C, Sahota O, Fox C. Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery. Cochrane Database Syst Rev. 2015;6:CD010569. Published 2015 Jun 15.

    Google Scholar 

  33. O’Sullivan D, O’Regan NA, Timmons S. Validity and reliability of the 6-item cognitive impairment test for screening cognitive impairment: a review. Dement Geriatr Cogn Disord. 2016;42(1–2):42–9.

    Article  PubMed  Google Scholar 

  34. Dutrieux RD, van Eijk M, van Mierlo ML, van Heugten CM, Visser-Meily JM, Achterberg WP. Discharge home after acute stroke: differences between older and younger patients. J Rehabil Med. 2016;48(1):14–8.

    Article  PubMed  Google Scholar 

  35. Everink IHJ, van Haastregt JCM, van Hoof SJM, Schols JMGA, Kempen GIJM. Factors influencing home discharge after inpatient rehabilitation of older patients: a systematic review. BMC Geriatr. 2016;16:5.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Vluggen TPMM, van Haastregt JCM, Tan FES, Kempen GIJM, Schols JMGA, Verbunt JA. Factors associated with successful home discharge after inpatient rehabilitation in frail older stroke patients. BMC Geriatr. 2020;20:25.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Everink IHJ, van Haastregt JCM, Maessen JMC, Schols JMGA, Kempen GIJM. Process evaluation of an integrated care pathway in geriatric rehabilitation for people with complex health problems. BMC Health Serv Res. 2017;17(1):34.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands

    Wilco Achterberg & Monica van Eijk

  2. Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands

    Van Haastregt Jolanda

  3. Department of Medicine for Older People, Amsterdam University, Amsterdam, The Netherlands

    Ewout Smit

Authors
  1. Wilco Achterberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Van Haastregt Jolanda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ewout Smit
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Monica van Eijk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wilco Achterberg .

Editor information

Editors and Affiliations

  1. California Association of Long Term Care Medicine, Newbury Park, CA, USA

    Michael R. Wasserman

  2. Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA

    Debra Bakerjian

  3. Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA

    Sunny Linnebur

  4. Division of Geriatrics, SUNY Upstate Medical University, Syracuse, NY, USA

    Sharon Brangman

  5. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Matteo Cesari

  6. Section of Geriatric Medicine, Division of Internal Medicine, Department of Medicine, Cedars-Sinai, Beverly Hills, CA, USA

    Sonja Rosen

Section Editor information

  1. Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, California, USA

    Debra Bakerjian PhD, APRN, FAAN, FAANP

Rights and permissions

Reprints and permissions

Copyright information

© 2024 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Achterberg, W., Jolanda, V.H., Smit, E., van Eijk, M. (2024). Geriatric Rehabilitation. In: Wasserman, M.R., Bakerjian, D., Linnebur, S., Brangman, S., Cesari, M., Rosen, S. (eds) Geriatric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-74720-6_120

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-74720-6_120

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-74719-0

  • Online ISBN: 978-3-030-74720-6

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation