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In his 87th year of life, the great Michelangelo Buonarrotti (1475–1564) was believed to have said, "Ancora imparo" ("Still, I am learning")


By the end of this chapter, readers will be able to:

  1. Relate the demographics of disability in the older adult to the extent of problems that may be encountered during rehabilitation.

  2. Outline the unique aspects of rehabilitation as they relate to the older adult.

  3. Discuss the different team approaches to the rehabilitation of the older adult and the complementary relationship between occupational therapy and physical therapy.

  4. Define comprehensive assessment as it relates to rehabilitation of the older adult.

  5. Review common assessment tools and interventions used in older adult rehabilitation settings.

  6. Discuss the personal and environmental factors that may enhance or impede the rehabilitation process.

  7. Describe the various delivery systems in which rehabilitation of the older adult can take place and the related reimbursement issues.

  8. Consider the psychological impacts of trauma and illness on the rehabilitation process.

  9. Outline rehabilitation issues for older adults with preexisting conditions.

Clinical Vignette

My Uncle Alphonse

When we were little he always had candies in his pocket and would take us for ice cream. He always played lots of games, card games, sports, board games as long and as often as we all wanted to play.

When I was older, he was interested in what I wanted to do when I grew up, who I was dating, and what I did for fun. He had the biggest laugh. My mother says he also has a bad temper when they were growing up, but I never saw it.

When I was 14, he married Sophia, who was a fashion model and very cool. A few years later, he had babies of his own, but he was still interested in our lives and what we were doing. He was an importer/exporter; he traveled all over the world. He loved work, he said, and he loved play, and he loved people, he loved his nieces and nephews and his own children, and God. He lived a big life. He had lots of strong opinions but could laugh at himself too. He danced at my wedding, toasted my bride, and later spoiled my own children as he had spoiled me. He took up waterskiing and golf and bird watching. He said he wanted to live life to the fullest each and every day.

When he was 67, he fell off his roof and hurt his back. With his back injury, he experienced significant pain and disability for the first time in his life. The loss affected all areas of his life and his health and resulted in grieving and depression. He focused his life on a search for a cure. He tried acupuncture, and cold packs, and drugs, and prayer, and massage, and psychotherapy, and naturopathy, and finally he tried surgery in the hope that he would have less pain and ...

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