[The elderly patient during medical rehabilitation - problems and needs]

The German population faces an increasing proportion of the elderly. These changes are also reflected in the age composition seen in clinics for medical inpatient rehabilitation. The disease-related discomforts of elderly rehabilitants differ from the troubles faced by younger age-groups. Age-specific rehabilitation programmes and therapies play a key role in enabling long-term participation in occupational and societal life. This article explores age-specific expectations and aims towards medical rehabilitation among members of statutory pension funds aged 55 and above, their health-related problems and the status-quo of rehabilitative programmes. Using the data of 1 008 patients of orthopaedic medical inpatient rehabilitation, we assessed age-specific differences in the utilisation, provision and success of rehabilitation programmes, and in the satisfaction with rehabilitative measures. The data indicate distinctive health-related problems and higher strains among elderly rehabilitants. However, they enter the rehabilitation process with less and rather impeding expectations, their rehabilitation aims primarily focussing on their dominant health problems. Current medical inpatient rehabilitation programmes and treatments seem to lack patient-orientation, obviously they do not address the specific needs of the elderly. Instead of serving individual needs, the rehabilitative treatments seem to be administered evenly across all patients. Compared to younger age-groups, older patients benefit less from rehabilitation programmes. Their expectations concentrate very much on retirement, thus increasing their risk to retire from work. A patient-centred rehabilitation programme should at an early stage take on the specific strains and expectations of elderly rehabilitants and develop manageable solutions. The process could be supported by stronger involvement of and cooperation with the patient's general practitioner. Further suggestions are being developed by an ongoing research project.