Summary
Specialists in physical medicine and rehabilitation are important partners during the ageing process: health promotion and prevention for fit elderly people, training and rehabilitation for prefrail people and support for frail people focusing on usage of what is left and dignity in the latest period of life. The main focus is the relationship between IC diagnoses and functioning in everyday life based on the International Classification of Functioning (ICF). The diseases lead to possible treatments; functioning shows the importance of rehabilitative strategies in a team approach. Physiatrists are experts on this complex issue.
The main goal of rehabilitative strategies during life course is to maintain function, improve quality of life and delay dependency and need of care.
Three settings are chosen to show the different aspects of physical medicine and rehabilitation: health promotion and prevention, rehabilitation and palliative-rehabilitative procedures in long-term care. The non-pharmaceutical treatment of pain, the geriatric assessment, knowledge in discharge management and team communications are important skills.
Zusammenfassung
Fachärzte für Physikalische Medizin und Rehabilitation sind wichtige Wegbegleiter älterer Menschen vom relativen Wohlbefinden mit guter Alltagsfunktion bis hin zur Pflegeabhängigkeit. Der Fokus liegt durch Diagnostik und Therapie den für den Patienten entscheidenden Bogen von ICD Diagnosen zu alltagsrelevanten Funktionen und Teilhabe zu spannen. Letztlich entscheidet die Organdiagnose über die therapeutischen Möglichkeiten, die Funktionsdiagnose aber über den Therapiebedarf. Die ICF – International Classification of functioning – stellt das zugrundeliegende Konstrukt.
Im Rahmen der Leitung des multiprofessionellen Teams wird nach Analyse von Defiziten und Ressourcen ein komplexes Rehabilitationskonzept entwickelt. Es ist das Ziel alltagsrelevante Funktionen und die Lebensqualität zu erhalten oder zu verbessern und die Pflegebedürftigkeit zu verzögern.
An Hand von drei Settings wird die Breite des Aufgabengebietes dargestellt: Gesundheitsförderung und Prävention, Rehabilitation und palliativ-rehabilitative Maßnahmen in der letzten Lebensphase. Die nicht medikamentöse Schmerztherapie, das Geriatrische Assessment, das Nahtstellen- und Entlassungsmanagement, sowie die regelmäßige Teambesprechung sind relevante Instrumente.
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Pils, K. Aspects of physical medicine and rehabilitation in geriatrics. Wien Med Wochenschr 166, 44–47 (2016). https://doi.org/10.1007/s10354-015-0420-3
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DOI: https://doi.org/10.1007/s10354-015-0420-3