Geriatric rehabilitation as an integral part of geriatric medicine in the Nordic countries

2.50
Hdl Handle:
http://hdl.handle.net/2336/4632
Title:
Geriatric rehabilitation as an integral part of geriatric medicine in the Nordic countries
Authors:
Jonsson, Arsaell; Gustafson, Yngve; Schroll, Marianne; Hansen, Finn Rønholt; Saarela, Mika; Nygaard, Harald; Laake, Knut; Jonsson, Palmi V; Valvanne, Jaako; Dehlin, Ove
Citation:
Dan Med Bull 2003, 50(4):439-45
Issue Date:
1-Nov-2003
Abstract:
OBJECTIVES: First, to outline the theoretical and practical framework for geriatric rehabilitation in the Nordic countries and second, to survey the scientific medical publications for evidence-based geriatric rehabilitation. METHODS: Brainstorming on geriatric rehabilitation in a working group of Nordic teachers in geriatric medicine. Papers on scientific programmes for geriatric rehabilitation from Internet sources were collected and analyzed. All articles describing randomized studies in geriatric rehabilitation were selected for meta-analyses. The papers were divided into four groups according to diseases, infirmity and resource settings: stroke, hip-fractures, acute admissions and programmes conducted in nursing homes, day hospitals and home services. RESULTS: The literature survey included 30 scientific studies (9496 patients) in randomized trials with valid endpoints. Geriatric rehabilitation programmes for stroke patients in geriatric settings (six papers, 1138 patients) reduced mortality and the need for nursing home placement, but the outcome for ADL function was not significantly changed. Function and length of stay varied between the studies. The outcome of geriatric rehabilitation was even more decisive in the randomized hip-fracture studies (seven articles, 2414 patients): the readmission rate and cost were significantly better. Ten studies were found, comparing the outcome of acute admissions of frail elderly patients (4683) with either geriatric (GEMU, GRU) or general medical wards. The effect of rehabilitation regarding mortality rate at one year, placement in a nursing home, physical function, contentment with services, readmission rate and cost was significant improvement in the geriatric settings. Internal comparisons of geriatric programmes in nursing homes, day hospitals and in-home services (seven studies, 1261 patient) revealed some differences in outcomes regarding function, contentment and costs. CONCLUSION: Specialized geriatric rehabilitation is complicated but effective when properly performed. Interdisciplinary teamwork, targeting of patients, comprehensive assessment and intensive and patient-targeted rehabilitation seem to characterize the most effective programmes. Rehabilitation of frail elderly people poses a major future challenge and has to be developed further for the sake of elderly people's quality of life as well as economic reasons.

Full metadata record

DC FieldValue Language
dc.contributor.authorJonsson, Arsaell-
dc.contributor.authorGustafson, Yngve-
dc.contributor.authorSchroll, Marianne-
dc.contributor.authorHansen, Finn Rønholt-
dc.contributor.authorSaarela, Mika-
dc.contributor.authorNygaard, Harald-
dc.contributor.authorLaake, Knut-
dc.contributor.authorJonsson, Palmi V-
dc.contributor.authorValvanne, Jaako-
dc.contributor.authorDehlin, Ove-
dc.date.accessioned2006-09-26T16:07:24Z-
dc.date.available2006-09-26T16:07:24Z-
dc.date.issued2003-11-01-
dc.identifier.citationDan Med Bull 2003, 50(4):439-45en
dc.identifier.issn0907-8916-
dc.identifier.pmid14694856-
dc.identifier.otherGER12-
dc.identifier.urihttp://hdl.handle.net/2336/4632-
dc.description.abstractOBJECTIVES: First, to outline the theoretical and practical framework for geriatric rehabilitation in the Nordic countries and second, to survey the scientific medical publications for evidence-based geriatric rehabilitation. METHODS: Brainstorming on geriatric rehabilitation in a working group of Nordic teachers in geriatric medicine. Papers on scientific programmes for geriatric rehabilitation from Internet sources were collected and analyzed. All articles describing randomized studies in geriatric rehabilitation were selected for meta-analyses. The papers were divided into four groups according to diseases, infirmity and resource settings: stroke, hip-fractures, acute admissions and programmes conducted in nursing homes, day hospitals and home services. RESULTS: The literature survey included 30 scientific studies (9496 patients) in randomized trials with valid endpoints. Geriatric rehabilitation programmes for stroke patients in geriatric settings (six papers, 1138 patients) reduced mortality and the need for nursing home placement, but the outcome for ADL function was not significantly changed. Function and length of stay varied between the studies. The outcome of geriatric rehabilitation was even more decisive in the randomized hip-fracture studies (seven articles, 2414 patients): the readmission rate and cost were significantly better. Ten studies were found, comparing the outcome of acute admissions of frail elderly patients (4683) with either geriatric (GEMU, GRU) or general medical wards. The effect of rehabilitation regarding mortality rate at one year, placement in a nursing home, physical function, contentment with services, readmission rate and cost was significant improvement in the geriatric settings. Internal comparisons of geriatric programmes in nursing homes, day hospitals and in-home services (seven studies, 1261 patient) revealed some differences in outcomes regarding function, contentment and costs. CONCLUSION: Specialized geriatric rehabilitation is complicated but effective when properly performed. Interdisciplinary teamwork, targeting of patients, comprehensive assessment and intensive and patient-targeted rehabilitation seem to characterize the most effective programmes. Rehabilitation of frail elderly people poses a major future challenge and has to be developed further for the sake of elderly people's quality of life as well as economic reasons.en
dc.language.isoenen
dc.publisherDanish Medical Associationen
dc.subject.meshAgeden
dc.subject.meshDenmarken
dc.subject.meshDisability Evaluationen
dc.subject.meshFinlanden
dc.subject.meshGeriatric Assessmenten
dc.subject.meshGeriatricsen
dc.subject.meshHealth Services for the Ageden
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshRehabilitationen
dc.subject.meshScandinaviaen
dc.titleGeriatric rehabilitation as an integral part of geriatric medicine in the Nordic countriesen
dc.typeArticleen
dc.identifier.journalDanish Medical Bulletinen
dc.format.digYES-

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