Rehabilitation in the elderly

The prerequisites for effective rehabilitation programmes in elderly patients are described, taking into account the specific social, physiological and psychological changes associated with senescence. The special problems facing elderly patients admitted to hospital are discussed and how their needs can be met. The importance of dementia as a factor influencing rehabilitation is considered and the various forms of residential and non-residential care described. Similarly, the paramount importance of accurate diagnosis of the causes of confusional states is emphasized and principles of management described. The fruitfulness of effective liaison between the psychiatrist and geriatrician is underlined and various ways by which this can be achieved, including the place of psychogeriatric assessment unit, and the role of the acute geriatric ward and geriatric rehabilitation unit. The principles of management of the elderly mentally ill in hospital are outlined. As specific examples of the principles and problems of rehabilitation programmes for disorders in the elderly, a detailed description is presented of the rehabilitation of the patient with myocardial infarction and the patient who has developed a hemiplegia following a cerebrovascular accident.