Beneficiaries of the Medicare program have three rehabilitation-related benefits established by federal statute: physical therapy rehabilitation, occupational therapy, and speech-language therapy (speech-language pathology). All therapists, who must be graduates of accredited programs, must pass a national examination and be licensed, certified, or registered in their respective professions within the state in which the services are furnished. Medicare covers services that are necessary and likely to result in improvement in a reasonable period of time. Medicare does not currently regard prevention services provided by therapists as falling under therapy benefits and will not cover services intended to maintain a current level of function. (more…)

Aging begins before we are born, is a lifelong process and continues throughout life. Throughout the life course, differing life experiences influence our capabilities and well-being in our later years. The functional capacity of our biological systems increases during the first years of life, reaches its peak in early adult-hood and naturally declines thereafter. Throughout most countries (but not all), persons experience a long childhood and a long old age. These two lengthy developmental spans have provided great utility. Throughout history, it has enabled older persons to educate the younger and pass on values to them. (more…)

Activities of Daily Living (ADLs) is the core daily personal care activities that are necessary in order for people to be able to live independently. Loss of mental functioning is measured by other standardized tests and referred to as cognitive impairment. Activities of Daily Livings are particularly important because along with cognitive impairment, and in some cases “medical necessity,” they are the mechanism used by the insurance industry to determine qualification for long-term care benefits and may also be used to determine qualification for admission to a nursing or assisted living home facility. (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 is strong consensus among geriatricians and gerontologists that frailty is a clinical state of increased vulnerability and decreased ability to maintain homeostasis that is age-related problems and centrally characterized by declines in functional reserves across multiple physiologic systems. This vulnerability is age-related and also related to, but distinct from, disability and elderly disease states. (more…)

Growing older results in the various changes in the anatomy and physiology of human cardiovascular system. This affects in both healthy patients and patients with hypertension. The heart gets a less powerful pump, and needs to bring more to do the same job. (more…)

There are two basic considerations on how to prevent accidents and injuries in elderly. First of all, we should make our surroundings safe by removing or altering objects that are hazardous. And secondly, we should learn how to handle ourselves so as to reduce the likelihood of injury. (more…)

New Zealand also initiated an Older Peoples Health Strategy with the following eight objectives:

• Older people, their families, and whanau (Maori expression for extended family) are able to make well-informed choices about options for healthy living, health care for elderly, and/or disability support needs. (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…)

The systemic benefits of exogenous Growth Hormone therapy in the healthy elderly remain unclear and controversial. Studies have not been able to demonstrate a clear anabolic effect of replacement of Growth Hormone in elderly subjects, possibly because Growth Hormone replacement cannot completely correct the alterations in binding recommended proteins. (more…)