In this new edition, the readibility has been enhanced with streamlined text, added subheadings, introductions, and conclusions to each chapter. The special needs of the elderly in all health care settings is the unifying element of this book. It emphasizes a balance of theory, clinical application of knowledge, and clinical skills in caring for the older adult population, and focuses on the practical components for their comprehensive rehabilitation. This book addresses and incorporates aspects of prevention, fitness, and wellness into the rehabilitative model of care for elders with and without pathological conditions.
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Going beyond theory and progressing into realistic, practical application in a clinical setting, the second edition of Geriatric Rehabilitation continues to emphasize the special needs of the elderly in all health care settings. Balancing theory and clinical skills in caring for older adults, this text focuses on the practical components of their rehabilitation. It incorporates aspects of prevention, fitness, and wellness into the rehabilitative model of care.
The second edition of this text adds all of the information that has been requested over the years by readers of the first edition, to enhance their practice of geriatric rehabilitation. The authors have incorporated material from the first edition and expanded each chapter to provide the most up-to-date information possible. As new research and evidence-based practice have evolved in the area of geriatrics over the past few years, much of the information in the first edition has been reviewed, substantiated, and enhanced. This edition provides a comprehensive overview of current science and practice in geriatric rehabilitation. The second edition addresses a wider scope of clinical issues than the first to meet the multiple needs of its readers in managing the geriatric patient. It is the authors' strong belief that the current and future success of geriatric practitioners lies in their ability to ground the practice of geriatric rehabilitation in the foundational, sciences and in the concepts and principles of evidence-based geriatric practice.
This book was initially developed to address the need for a geriatric rehabilitation text that transcended the classical clinical and academic texts currently available. The many professions involved in geriatric rehabilitation have evolved rapidly in the past decade, but textbooks have not kept pace with the need for specialized clinical information. With the inauguration of a geriatric specialty examination in rehabilitation therapies, the need became more pressing. This book is designed to provide a single, comprehensive source for the advanced applied science of normal and pathological aging, clinical problems, implications for therapeutic interventions, and considerations specific to the elderly.
The main objective of this textbook is to present therapists with a thorough review of advanced clinical information. The targeted audience for this text is clinicians already exposed to geriatric patients who seek to improve their background and skill level. In addition, advanced master's and doctoral students seeking specific clinical information will find relevant material in the text.
At the time the first edition of this text went into publication, a small group of rehabilitation therapists had successfully passed the first geriatric specialty exam. Many of these therapists, however, had difficulty locating up-to-date information to prepare for the exam, or finding a comprehensive source of information. The authors believe this text addresses both of these criteria.
Both of the authors have worked extensively in the field of geriatrics. They have combined their knowledge to provide clinical information that is grounded in the literature and research-based references.
The text is divided into three parts. Part I provides advanced applied gerontological concepts. These chapters contain the most recent background information available and provide a clinically useful basis for a sound foundation for the following two sections.
Part I covers the important areas of demographic trends in the aging population as well as theories of aging and their impact on clinical strategies. Thorough descriptions of age-related changes in the biology, physiology, anatomy, and functioning of all organ systems of the body are provided, as well as a comprehensive examination of pathological manifestations commonly seen in the aged population.
Descriptions of detailed psychological aspects of aging and a presentation of tools that can be used to evaluate and treat these conditions are provided for the clinician. Background information on assessment tools, particularly functional assessment tools, is presented to provide the reader with objective indices for thorough evaluation in a variety of settings.
Part I also incorporates a clear explanation of some of the common nutritional problems and risk factors seen in the older population, as well as a discussion on the components of good nutritional programs. An emphasis on prevention and health promotion related to dietary considerations is provided. Finally, identification of various drug regimens, adverse drug reactions, and common pathologies seen with inappropriate drug management afford a practical approach to identifying pharmacological aspects of patient intervention. As many of our elderly clients have sought alternative therapies for management of various conditions, a section on herbs, vitamins, and nutraceuticals has been added.
Part II presents a comprehensive consideration of patient care concepts. This section begins with an overview, "Principles and Practices in Geriatric Rehabilitation," which bridges the gap between the background information presented in Part I and advanced clinical concepts. Understanding the importance of immobility and disuse is emphasized. This section provides an introduction to evaluation and presents therapeutic suggestions for common problems, including treatment design and rationale.
Strategies for evaluating and treating orthopedic, neurologic, cardiopulmonary, and integumentary conditions contribute invaluable means for comprehensively addressing problems commonly seen in an elderly population. Practical suggestions guide the rehabilitation therapist in establishing and implementing health maintenance programs, such as the provision of screening programs as a means of preventive health care and early intervention to avoid the pathological consequences of "hypokinetics."
Part III covers administration and management. Effective communication with the aging population is discussed, as well as the evaluation of personal attitudes, cultural biases, ethnic considerations, and other factors relating to the care of the elderly. A discussion of educational services and objectives for the elderly with a differentiation of various learning theories applied to the older population completes this section.
Practical information is also provided on the identification and description of geriatric rehabilitation services, and includes how to address administrative needs, prepare budgets, and develop marketing proposals for nursing homes and outpatient facilities. The role of the consultant and the development of the consultative tasks for geriatric specialists are presented. A thorough discussion of methods for reviewing research includes identifying the various aspects of a research proposal and an examination of research characteristics that make clinical data collection unique for an aging population. Finally, the network of resources available for the older person, including legislative, social, and federal programs, disease-specific organizations, and research grant availability are presented in a user-friendly style. The one-stop information resource provides current contact information and internet sites for the most appropriate services.
The authors hope that this book provides a strong clinical foundation for practicing geriatric therapists, and that it will facilitate the provision of optimum care to their elderly patients.
Jennifer M. Bottomley, PT, MS, PhD.
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