Elder Health Care

Geriatric Physical Therapy is a branch of rehabilitation dealing with elder health care. It involves alleviative or remedial, preventive or social aspects of the elderly disabled and disadvantaged people.

Geriatrics is the branch of medicine dealing especially with the problems of ageing and disease of the elderly. With the advancement of science and medical technology the general health of population has improved leading to an increase in elderly population. People are classed as elderly on reaching upto the age of 60 years but in 21st century medical, economic, social factors and high standards of living have increased the life expectancy upto 75 years. Prevention of disease and disability in the elderly is of paramount importance to improve their quality of life. Elderly are lonely and often entirely dependent on their children and relatives.

The majority of elderly are weak, frail and disabled including those with severe functional impairment requires special care and depends to a greater extent on the rehabilitation team therefore a special branch of geriatric physiotherapy has been introduced which particularly works for the rehabilitation of the elderly.

Characteristics of disease in old age:

• Multiple pathologies.
• Cryptic or unclear presentation.
• Rapid deterioration if not treated.
• Rehabilitation needed.
• Social environment, or psychological factor important.
• High incidence of secondary complications.

Common Elder Health Care Problems:

Epidemiological , experimental and interventional studies have proved that age related physiologic alterations occur at variable intensity in different organ systems.

Rheumatology:

• Inflammatory, degenerative and metabolic arthropathies.
• Osteoarthrosis.
• Patient complains of pain and restriction of movement.

Orthopaedics related diseases:

• Fracture neck of femur and surgical neck of humerus are prevalent injuries in elderly.
• Problems or complications associated with joint replacement surgery requiring rehabilitation to restore fitness and encourage independence to reduce disability and improve elder health.
• Deformities can also be disabling for example, hallux rigidus, hallux valgus, hammer toe etc.
• Injuries to soft tissue structures like tendinitis, bursitis or capsulitis can occur.

Cardiovascular diseases:

• Myocardial ischaemia.
• Myocardial infarction.
• Congestive cardiac failure.
• Valvular heart disease.
• Deep vain thrombosis.
• Varicose veins.
• Leg ulcers.

Respiratory diseases:

• COPD and asthma.
• T.B (lung).

Neurological diseases:

• Cerebral atherosclerosis resulting in CVA, which may further result in hemiplegia.
• Cervical spondylosis.
• Parkinsonism, featuring slowness of movement.
• Various thrombo embolic syndrome.
• Cognitive impairment, which leads to dementia.

Infections:

• Pneumonia.
• T.B.
• Urinary tract infection.

Alimentary diseases:

• Peptic ulcer.
• Hiatus hernia.
• Carcinoma of stomach and rectum.

Dietary disorders:

• Vitamin B12 deficiency.
• Iron deficiency.
• Pellagra.
• Vitamin D deficiency.
• Scurvy.
• Protein deficiency.

Diabetic:

• Neuropathy.
• Retinopathy.
• Ulcers.

Apart from dealing with these diseases of the elderly, physical therapist should look upon other age related problems like upliftment of general health of the elderly and induce fitness.

Elder health care problems other than these systemic diseases are:

• Impaired hearing process.
• Musculoskeletal system degrades, bones become weak and fragile prone for osteoporosis.
• Learning process or the short term memory is impaired.
• Diminished eyesight.

Old Aged handicaps:

In elderly people, inactivity creates variety of problems:

• Muscle weakness.
• Pain.
• Stiffness.
• Neurological deficits.

Which leads to inability to do various self care activities and activities of daily living and thus makes the elderly dependent on others for the fulfillment of his/her needs. This incapability requires rehabilitation such that by learning certain physiotherapy skills patient may improve his capability to some extent.

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