Mau W, Reuter S
Institut für Rehabilitationsmedizin, Martin-Luther-Universität Halle-Wittenberg.
Dtsch Med Wochenschr. 2011 Oct;136(43):2199-204. doi: 10.1055/s-0031-1292033. Epub 2011 Oct 18.
Considering the increasing disability with higher age and the demographic changes health promotion, prevention and rehabilitation are of high relevance for the maintenance and restoration of activity and participation of the elderly. Among the most important goals of prevention are mobility including physical activity and prevention of falls, adequate nutrition, maintenance of mental health, social integration and function. Different conditions of geriatric rehabilitation in Germany focussing either on acute care hospitals with early rehabilitation (inpatient or outpatient) or on rehabilitation in specialized centres lead to regional disparities. The application for rehabilitation measures has to consider the need, ability to participate, specified goals and prognosis after the interventions. Disease specific rehabilitation has to be differentiated from general geriatric rehabilitation addressing typical multimorbidity and geriatric syndromes. Significant characteristics of geriatric rehabilitation are regular patient oriented discussions within the multi-professional and interdisciplinary team coordinated by geriatricians. This includes prioritizing the patient's problems according to their significance and availability of effective therapy, evaluation of the results and adjustment of treatment goals if necessary. Standardised geriatric assessments should be applied. Geriatric rehabilitation including the interdisciplinary team increases function and reduces the risks of nursing home admissions and mortality. Therefore, the access to and the capacities of geriatric rehabilitation should be further improved.
鉴于随着年龄增长残疾情况日益增多以及人口结构变化，健康促进、预防和康复对于老年人维持和恢复活动能力及参与度具有高度相关性。预防的最重要目标包括身体活动在内的行动能力以及预防跌倒、充足营养、维持心理健康、社会融入和功能。德国老年康复的不同情况，有的侧重于设有早期康复（住院或门诊）的急症医院，有的侧重于专科中心的康复，这导致了地区差异。康复措施的申请必须考虑需求、参与能力、特定目标以及干预后的预后。特定疾病的康复必须与针对典型多重疾病和老年综合征的一般老年康复区分开来。老年康复的显著特点是在由老年病医生协调的多专业和跨学科团队中定期进行以患者为导向的讨论。这包括根据问题的重要性和有效治疗的可行性对患者问题进行排序、评估结果并在必要时调整治疗目标。应采用标准化的老年评估。包括跨学科团队在内的老年康复可增强功能并降低入住养老院的风险和死亡率。因此，应进一步改善老年康复的可及性和能力。
