What is geriatric rehabilitation?
Inevitable physiological changes occur in our bodies as we age. The addition of extra health problems on top of these changes makes elderly individuals more vulnerable compared to other age groups. All of this impairs the quality of life of the elderly person and causes significant increases in overall healthcare expenses.

Preserving the quality of life of elderly members of society and enabling them to live actively is a shared responsibility—not only of healthcare professionals but also primarily of the family and society as a whole. Geriatric rehabilitation is a concept encompassing all efforts to maximize the functional status of elderly people in cases of physical disability, illness, or impairment. The entire range of services offered to prevent or minimize functional deterioration caused either physiologically or by disease fall under the umbrella of rehabilitation in the elderly.

Why is geriatric rehabilitation necessary?
Everyone wants to restore their diminished quality of life to a desired level. The fundamental goal is to improve the quality of life of the aging individual as effectively and economically as possible. To achieve this goal, geriatric rehabilitation becomes a necessity. With some simple and inexpensive methods and treatments, both the patient’s quality of life can be improved and the societal economic burden reduced.

How is geriatric rehabilitation implemented?
A key principle to remember in geriatric rehabilitation is that each patient has unique needs. Therefore, the rehabilitation program should be individualized to increase the chance of success.

First and foremost, the patient’s functional status should be evaluated and their level of function determined. Then, taking into account the person’s cognitive, cultural, social, family, economic, and physiological conditions, goals should be set within the means available. Planned goals and the rehabilitation process must be shared with the patient’s relatives to avoid unrealistic expectations.

When should geriatric rehabilitation begin?
Although there is no definite answer to questions like where, how long, and when to start, research has been ongoing in developed countries for years. Although rehabilitation programs are tested to reach the best outcomes, today the most important criteria for selecting rehabilitation methods and goals are the practical experiences and expertise of physicians.

Correct patient selection, efficient use of resources, and enabling a greater number of patients to benefit from services should be the aims. Certain standards must be established, and a good geriatric assessment should be performed. Physical therapy and rehabilitation specialists should be central in these assessments. General principles include:

• Rehabilitation programs should start early,
• It should be multidisciplinary, meaning various professionals work collaboratively,
• The rehabilitation program should begin slowly and simply,
• The patient should be encouraged to actively participate in the program,
• The patient-team relationship should be based on trust and assistance,
• Maximum possible mental and physical continuity should be targeted.

Where should geriatric rehabilitation be applied?
It can be conducted mainly in hospitals, rehabilitation centers, specialized nursing homes, retirement homes, clinics, and at home.

• Hospitals generally serve as the main headquarters where patients’ diagnostic tests and evaluations are performed, short-term treatments are administered, and discharge planning for future rehabilitation needs is made. It is decided here which settings will meet the patient’s rehabilitation needs afterward.
• Rehabilitation centers usually include all healthcare workers and provide specialized rehabilitation programs tailored to the patient. They often offer more intensive rehabilitation services than other units.
• Specialized nursing homes are inpatient facilities providing care and protection for elderly needing special care, with varying features.
• Retirement homes mainly aim to provide a peaceful environment for the elderly, addressing their care, social, and psychological needs, either part-time or full-time.
• Outpatient services at hospitals or centers like Rommer Physical Therapy and Rehabilitation Medical Center provide all types of rehabilitation and exercise programs in a comfortable setting.
• Home-based rehabilitation mainly involves programs accompanied by therapists, nurses, or other healthcare personnel.

What should be done in geriatric rehabilitation?
The main goal of physical activities applied to the elderly should be to increase functional capacity. Increasing this capacity will enhance quality of life. The aim of exercises is to include all muscle groups in activity, have appropriate rest periods following short exercise sessions, and consist of simple exercises with many repetitions. The purposes of exercise in the elderly include:

• Integrating and socializing the elderly with other people,
• Improving physical condition and capacity,
• Providing necessary muscle strength for daily activities,
• Ensuring balance to prevent falls.

The benefits of exercise in the elderly are notably positive:

• Reaction time shortens,
• Bone mass is maintained, reducing osteoporosis risk,
• Balance and posture improve,
• Increased muscle mass reduces fracture risk,
• Joint flexibility, muscle strength, and endurance increase,
• Positive effects on diseases such as obesity, diabetes, hypertension, and hyperlipidemia.

Rehabilitation programs for the elderly should be realistic, planned, repeated regularly, and modified as needed. Existing functions should be preserved while improving quality of life for the remainder of life, helping the individual to remain independent and social. Rehabilitation should be tailored individually to positively affect each elderly person’s recovery.

Future and expectations in geriatric rehabilitation
The geriatric rehabilitation team typically consists of a physical therapy and rehabilitation specialist leader, along with doctors, physiotherapists, occupational therapists, speech therapists, psychologists, nurses, nutritionists, orthotics-prosthetics specialists, and other experts.

Preventive medicine should always be prioritized during geriatric rehabilitation. The needs of the elderly should be identified before they become dependent or ill, and necessary precautions should be taken. Responsibility should not be left solely to healthcare professionals; this duty belongs to family members before illness or dependency occurs.

Family members are natural team members and should be informed and encouraged to take responsibility. Physical and emotional overload on family members should be avoided, empathy shown, and vigilance maintained against possible depression or other psychological problems.

If precautions are insufficient or additional diseases occur in the geriatric patient, professional healthcare workers should be involved.