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老年康复的具体特征:目标群体、服务内容、可及性

[Specific characteristics of geriatric rehabilitation: target groups, offers, access].

作者信息

Lübke Norbert

出版信息

Dtsch Med Wochenschr. 2022 Aug;147(15):973-981. doi: 10.1055/a-1646-5738. Epub 2022 Aug 1.

Abstract

Geriatric rehabilitation is an interdisciplinary offer of rehabilitation services for elderly persons who often have several impairments and, in some cases, an already existing need for nursing care. It aims at maintaining their self-determined participation in everyday life to the greatest possible extent as well as at avoiding or reducing their needs for nursing care. Characteristic features of geriatric patients are high vulnerability due to an age-related reduction of reserves and often multiple chronic diseases. This is why the geriatric assessment and the multi-professional geriatric team present a correspondingly broad base.As a result of the vulnerability of geriatric patients, early rehabilitation that already starts during acute treatment in hospital is of great importance for their rehabilitative care. Of total German geriatric-rehabilitative care 75 % is inpatient- and 8 % day-care in hospital. These kinds of care are largely provided nationwide. Unfortunately, they often cannot make use of the entire rehabilitation potential of geriatric patients. Independent geriatric rehabilitation facilities, however, are not available in all federal states yet and mainly focus on inpatients. They account for 17 % of geriatric-rehabilitative care - for more than 95 % in connection with a previous hospitalization. Up to now, there has not been an adequate focus on the utilization of out-patient and mobile geriatric rehabilitation as well as on the use of geriatric rehabilitation in case of a slowly progressing deterioration of activities and participation without any acute event. Especially, mobile rehabilitation that is directly performed at the patient's home constitutes a particularly suitable rehabilitation setting mainly for persons who will still need nursery care despite reaching their rehabilitation targets. But this kind of rehabilitation care is still little known.The article provides decision-making aids to physicians in hospitals and doctor's offices as well as information on how to gain access to geriatric-rehabilitative care services, including new regulations to facilitate this access, which are planned for 01 July 2022.

摘要

老年康复是为老年人提供的跨学科康复服务,这些老年人通常有多种功能障碍,在某些情况下,已经有护理需求。其目的是尽可能最大程度地维持他们自主参与日常生活的能力,并避免或减少他们的护理需求。老年患者的特征是由于与年龄相关的储备功能下降以及往往患有多种慢性疾病而具有较高的脆弱性。这就是老年评估和多专业老年团队具有相应广泛基础的原因。由于老年患者的脆弱性,在医院急性治疗期间就开始的早期康复对他们的康复护理非常重要。在德国全部老年康复护理中,75% 是住院护理,8% 是医院日间护理。这类护理在全国范围内大量提供。不幸的是,它们往往无法充分利用老年患者的全部康复潜力。然而,并非所有联邦州都有独立的老年康复设施,且这些设施主要针对住院患者。它们占老年康复护理的 17%,其中超过 95% 与之前的住院治疗相关。到目前为止,对于门诊和移动老年康复的利用以及在没有任何急性事件但活动和参与能力缓慢恶化的情况下老年康复的使用,尚未给予足够的关注。特别是直接在患者家中进行的移动康复,对于那些即使达到康复目标仍需要护理的人来说,构成了一种特别合适的康复方式。但这种康复护理仍然鲜为人知。本文为医院和诊所的医生提供决策辅助工具,以及关于如何获得老年康复护理服务的信息,包括计划于2022年7月1日实施的便利获取此类服务的新规定。

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