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The proportion of elderly at any age without any chronic conditions is small, and disease can trigger a cascade of events resulting in functional deficits and disability. An increase in the number of activities with which an elder has difficulty increases linearly with comorbidity, that is, coexistent medical conditions that further complicate not only the genesis of a functional deficit but also its treatment. For example, rehabilitation for a stroke for an individual who also has painful, degenerative changes in the foot and a low tolerance for stressful activity secondary to angina with exertion would present a particular rehabilitation challenge. Yet, this example encapsulates geriatric rehabilitation specialist’s emphasis on care and function, not cure and disease. (more…)

To meet the needs of older people most countries have moved toward community-based care as a means of providing adequate and cost-effective care. Community-based care focuses around an integrated and more comprehensive approach to the special needs of older persons, their families, and the community. This type of model involves and requires inter-organizational collaboration and interdisciplinary cooperation. A community-based approach in social services and in health care is a strategic approach to meet the mounting demands for integrated health and social services for the elderly. Community health care usually includes both the health and social services sectors. (more…)

Aging is associated with progressive fibrosis of the sinoatrial node and AV conduction system, resulting in bradycardia, which may be further exacerbated by disease and medications, resulting in symptoms requiring permanent pacemaker implantation. More than 80% of pacemaker recipients in the United States are older than 65 years, and the median age is 75 years. As the population ages, it is anticipated that the number of older persons requiring permanent cardiac pacemakers, as well as the associated costs, will continue to rise. (more…)

The overarching goal of physical therapy rehabilitation is to return the individual to as close to the premorbid level of function as possible or, alternatively, to maximize a person’s current potential for function and maintain it as long as possible. This goal is achieved by promoting changes in the individual, by altering his or her physical health elderly or social environments, or by implementing a combination of both strategies. (more…)

There are a number of issues that must be considered in geriatric pain assessment. The major issues that merit attention are presence of comorbidities, mental status, depression in late life, limitations in ADLs, medications, and the importance of family and other support systems (see Depression; Social Networks, Support, and Integration). (more…)

Common beliefs about older workers include beliefs that they are physically unable to do their job; have a high rate of absenteeism; have a high rate of accidents; are less productive, less motivated, and less receptive to innovations than younger people; and are unable to learn. While these are rather commonly held beliefs, there are few actual data to support these assumptions; in fact, most research studies indicate that these stereotypes are inaccurate. (more…)

First and foremost, many of the services supported by the Aging Network would not exist without network funding and advocacy. Without network services, an essential tier of the continuum of long-term care would be lost—the one that bridges total independence in one’s own home and institutionalization. (more…)

As mentioned earlier, the tendency to reminisce as we grow older was regarded by many gerontologists as a pathology until Robert Butler showed it could be a highly positive way of integrating experiences and coming to terms with the past. As such, life review became a method for group therapy, creative writing groups, and as a source for living history drama. Some researchers went even further. They described elements of wisdom and aging creativity in the life review process. Not only were older adults of learning and expressing themselves, but because of their treasure house of past experience, they could also be ideal students and could make excellent teachers. (more…)

The majority of older adults who suffer from depression experience lower-level symptoms that do not meet diagnostic criteria for major depressive disorder. The DSM recognizes several well-defined disorders that are considered minor depressive states. Dysthymia is defined as presence of one of the two defining symptoms plus at least two other symptoms of depression continuously for a period of at least 2 years. This chronic, low-level depression typically manifests relatively early in life and is in fact less prevalent in older than in younger persons. (more…)

It is in this same period that college-and university-based Institutes for Learning in Retirement (ILRs, later renamed Lifelong Learning Institutes, or LLIs) arose. The prototype for subsequent LLIs was the Institute for Retired Professionals established in 1962 at the New School for Social Research (now New School University) in New York City. Only a handful of the member-led, member-taught, educational programs had appeared by the mid-1970s but by the mid-1980s there was a sharp rise in the rate of new programs started each year, until, by 2000, there were more than 400 of these programs across the United States and Canada. (more…)