Geriatric patient Above

4. INTRODUCTION TO GERIATRIC
PHYSICAL THERAPY
DPT-X

5. Reference Book
 GERIATRIC PHYSICAL THERAPY, THIRD EDITION
by Andrew A. Guccione

6. Lecture Outline
 What is geriatric
 What is Aging
 Role of Physical Therapist
 Issues related to Geriatric population
 Implication of an aging, population for Rehabilitation,
Demography, Mortality & Morbidity in the Elderly
 Physiological changes in elderly

7. Introduction
Geriatrics
 Is a sub-specialty of medicine that focuses on
health care of elderly people.
 It aims to promote health by preventing and
treating diseases and disabilities in older adults.
 40% of patients in rehab clinics

8.  Geriatric physical therapy was defined as a
medical specialty in 1989 and covers a broad area of
concerns regarding people as they continue the
process of aging, although it commonly focuses on
older adults.
 Gerontology: The scientific study of the factors
impacting the normal aging process and the effects of
aging.

9. AGING

10. Aging
typical changes
in physiological
functioning
observed in
older adults
unavoidable
aging-related
changes
avoidable
aging-related
changes
physical activity
nutrition
stress
management
Rowe and Kahn, mid 1980s

11. Rowe and Kahn
 Their perspective encourages practitioners to consider
that for many older adults, a considerable proportion of
apparent age-related changes in functional ability may be
partially reversible with lifestyle modification programs.
Life style
improvement
Improving
functional ability

12. Successful Aging
1. Absence of disease
and disability.
2. High cognitive and
physical functioning.
3. Active engagement
with life.
The specific
elements as
the signs of
an individual
who is aging
successfully
are

13. Average or Usual Aging
 Usual aging syndrome is one in which
suboptimal
lifestyle
chronic health
problems
Function
Ability to readily
engage in family or
community activities
Improving healthy lifestyle is encouraged as a means
of achieving successful aging.

14. Optimal Aging
“the capacity to function across many domains—
physical, functional, cognitive, emotional, social, and
spiritual—to one’s satisfaction and in spite of one’s
medical conditions.”
(Brummel-Smith)

15. Slippery Slope of Aging
 The Slippery Slope of Aging originally proposed by
Schwartz, represents the general decline in overall
physiological ability that is observed with increasing
age & its impact on function.
 Schwartz has embedded functional status thresholds
at various points along this slope.

16. Slippery Slope of Aging

18. Role of Physical Activity
and Exercise in Optimal Aging
 Sedentary lifestyle increases the rate of age-related
functional decline and reduces capacity for exercise
sustainability to regain physiological reserve following
an injury or illness.
 It is critical that physical therapists visibly address
sedentary behavior as part of the plan of care for their
older adult patients.
 Use of Outcome Tools
 Only 22% of engage - physical activity

19. Common problems in Elders
 HEALTH PROBLEMS
1.Joint problems
2.Impairment of special senses
3.Cardio vascular disease
4.Osteoprosis
5.Cancer, Diabetes & Accidental falls
 Psychological problems
1. Emotional problems
2. Suicidal tendency
3. dementia
 Social problems
Poverty, Loneliness, Dependency, Isolation, Elder abuse

20. Geriatric physical therapy
Is the branch of medicine that studies rehabilitation and physical
therapy issues in elderly.
 Normal aging due to disuse and deconditioning
 Cardiovascular problems like vascular disease and stroke
 Skeletal problems including osteoporosis and osteoarthritis
 Sensory impairments- lack of communication
 Prevention of falls
 Malnutrition
 Depression, delirium and dementia
 Pain
 ADLs and IADLs performance issues
 Others

21. Role as a physical therapist
 Increase restore or maintain ROM , physical
strength , flexibility , coordination, balance and
endurance
 Recommend adaptation to make the home
accessible and safe
 Teach positioning , transfer and walking skill
promote function and independence
 Increase fitness through exercise program
 Prevent further decline in functional abilities
through education , joint protection , and use of
assistive device
 Improve sensation , joint Proprioception
 Reduce pain

22. THE PATIENT-CENTERED PHYSICAL
THERAPIST ON THE GERIATRIC TEAM
 Physical therapists working with older adults must be
prepared to serve as autonomous primary care
practitioners, and as consultants, educators (patient
and community), clinical researchers (contributors
and critical assessors), case managers, patient
advocates, interdisciplinary team members, and
practice managers.

23. Clinical Expertise in Physical
Therapy
 Clinical expertise is one of the three anchors to EBP.
 Jensen and colleagues, through a series of well-
planned qualitative studies using grounded theory
methodology, identified four core dimensions of
expert physical therapist practice:
 virtue,
 Clinical Reasoning,
 Knowledge
 movement.
 These four dimensions provide a theoretical model to
examine professional development from novice to

24. Developing clinical expertise: Moving from
novice to expert practice.
 Student
 Novice
 Competent
 Master

25. Conceptual model illustrating the factors contributing
to the development of expertise in geriatric physical
therapy
 Types and sources of knowledge
 Mentors
 Patients
 Students
 Education

26.  Clinical reasoning
 Diagnosis and prognosis
 within disability framework
 Life span approach
 Motivation
 Management of multiple tasks

27.  Personal attributes
 Hunger for knowledge
 Do the right thing
 Energy
 Philosophy of practice
 Decision making
 Physicality
 Community
 Teaching

28. Evidence
Based
Practice
Clinical
experience and
judgment of
the
practitioner
Patient
preferences
and
motivations.
Best
available
scientific
evidence