The functional approach to the care of the elderly: a conceptual framework

A conceptual framework that is based on the biopsychosocial model and focuses on functional status is proposed for the understanding and teaching of the functional approach to health care. Functional status can be viewed as the composition of various biologic, psychologic, and social capabilities that are integrated in order to perform the activities necessary to ensure an individual's well-being. When functional status is threatened by aging or by disease-related deficits, a compensatory response is generated by mobilizing reserve resources/capabilities in an effort to maintain functional status. Since the aging process is characterized by the acquisition of multiple age- and disease-related deficits, primary care providers need to appropriately detect functional impairments through multidimensional assessment and orchestrate compensatory responses in an effort to restore, maximize, and maintain functional status and independence for as long as possible.