Principles of Geriatric Rehabilitation: Asmaun Nadjamuddin

PRINCIPLES OF GERIATRIC
REHABILITATION
Asmaun Nadjamuddin
Department of Medical Rehabilitation
RS Dr. WAHIDIN SUDIROHUSODO
Sooner or later geriatric need care
Medical Rehabilitation.
Medical Rehabilitation
Medical approach, psychology, social,

cultural, and spiritual for increase
functional ability from the patient or
handicap.
The aspect of Medical Rehabilitation is

very basic at geriatric treatment.
Functional capacity of a person can be
done even if the disability or old age.
Every activity of human organs whose

structure is healthy, get the training aims
to organs, and provide the benefits of
restitution of organ function.
ASSESSMENT OF
POTENCIALREHABILITATION
• Medical assessment
• Assessment of functional ability

Anatomy Diagnostic
Etiology Diagnostic
Functional Diagnostic

Target Functional Achievement
A: a representation of the gap between reality and hopes. B: improved quality of
life for the better is the hope of a reduction or change in the current reality.
REHABILITATION PROCESS
Step 1
• Determine the principal medical

problem
• Stable conditions is the first base of the
rehabilitation program.
Step 2
Prevention of Secondary Complication
Malnutrition Incotinence
Cognition Disorders Pneumonia
Contractures Decubitus
Decondition Syndrome Psychological Dependence
Depression Venous Thrombosis
Step 3
Return of the Lost Function
• Return the value of the remaining functional

ability and maximize it
• If needed, use the tool to be independent,
socializing
Although the cause of dysfunction can not be

removed, the patient is still capable of activity
Step 4
Create the ability

Adaptation for patients
Physical Adaptation
Psychological Adaptation
Social Adaptation
Step 5
Environment Adaptation
Create the environmentally friendly,

both in hospital, at home, in environment, for
the convenience of patients in their activity
Step 6
Family Adaptation
• 85% geriatric activities at home

• The elderly need more time to 'receive'
condition
• Family is one meaning of life for the elderly
• Family is partner of medical/paramedics
CHOICE OF THERAPY PROGRAM
FOR MEDICAL REHABILITATION
• Rational Goal
• Proper Training and a Clear Dose
• Gradual Training
• This Type of Exercise is Easy and Safe
Monitoring and Evaluation
• Do reevaluation and reprogram

• Always set new targets for motivation
awake
• Target achievement is the agreement
of doctors and patients
Therapeutic Exercise
• Reguler and structured exercise
• Depending on the stability of the patient’s condition
• Provide information about exercise programs to
patients and families
• Give examples and apply them to patients
• Type of Exercise:
 LGS, istonic, isometric
 Advantages :
 Prevent deformity
 Maintain normal muscle tone and function
Therapeutic Exercise
• Range of motion exercises
 Passive : Done by nurses or therapists or caregiver
 Active : Done by patients
 Practice Area
Upper limb :
 Shoulder, elbow, wrist, fingers
Lower limb:
 Hip joint, knee joint
 Ankle joint, achilles tendon
 Legs, fingers
Tai Chi Chuan Calisthenics
Center pedestal : in area of limb,

especially the
knee muscles
Results : * endurance the quadriceps muscles
* coordination
* body balance
Advantages: * prevent falls
* function of cardio respiration
* flexing body
* balance
* feeling comfortable, happy, and
The old age is not an obstacle to
practicing prevent falls
Shummay - Cook,
Phys-Ther 1997
There should be quick and strong phase of

exercise, like brisk walking, advantages :
Multi-segmental coordination
Woolacott & Tang

Phys Ther 1997
The Recommended Practice :
• Ordinary walk-fast walk

• Tai-Chi
• Habitual resistance training
FIT-BUGAR
Fit– Bugar
is the condition of the body, where
energy reserves from heart, lungs, limbs and
other organs capable of optimal activity for
the usual activities of daily
CONCLUSION
• Rehabilitation approaches and

techniques can be used to compile the
elderly care program toward a healthy
and independent

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PRINCIPLES OF GERIATRIC

Medical approach, psychology, social,

The aspect of Medical Rehabilitation is

Every activity of human organs whose

• Determine the principal medical

Prevention of Secondary Complication

Return of the Lost Function

• Return the value of the remaining functional

Although the cause of dysfunction can not be

Create the ability

Create the environmentally friendly,

• 85% geriatric activities at home

• Do reevaluation and reprogram

Center pedestal : in area of limb,

There should be quick and strong phase of

Woolacott & Tang

• Ordinary walk-fast walk

• Rehabilitation approaches and

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