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“In his 87th year of life, the great Michelangelo Buonarroti (1475–1564) was believed to have said, “Ancora imparo” (“Still, I am learning”).”
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LEARNING OUTCOMES
By the end of this chapter, readers will be able to:
25-1. Describe the different service contexts in which geriatric rehabilitation can be delivered and why geriatric rehabilitation is believed to be effective for older adults.
25-2. Identify factors that may alter the role of the scope of the occupational therapist’s assessment and intervention and their role on the interprofessional team.
25-3. Create a reference resource of person-level factors that influence rehabilitation that the occupational therapist can identify during assessment and address during intervention.
25-4. Debate the role of the occupational therapist in identifying and addressing the impact of social determinants of health that may have an impact on the rehabilitation trajectory.
25-5. Identify two evidence-based interventions for older adults that can be delivered across settings and explain why they are believed to be effective.
25-6. Provide a rationale for the importance of documentation that supports transfer of patient information from one level of care to another.
25-7. Partner with interprofessional colleagues to address micro-, meso-, and macro-level constraints to accessing rehabilitation services.
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Mini Case Study
Mrs. Zelda Chompsky is 76 years old and widowed and lives alone. She is described by her family as having “so much zest for life, always painting, dancing, baking, planting, and helping others in need.” Mrs. Chompsky’s family found her lying on the kitchen floor when they arrived one evening for a family dinner. She was not fully conscious, so they called an ambulance. At the hospital, Mrs. Chompsky was diagnosed by medical staff with left middle cerebral artery stroke and underwent surgery to reduce the swelling in her brain. Mrs. Chompsky had weakness and poor sensation in her right arm and leg, was unable to get out of bed or walk on her own, had receptive aphasia and bladder incontinence, and was more anxious and cautious than her typical self.
While in the acute care ward, Mrs. Chompsky received physical therapy, occupational therapy, and speech-language therapy for post-operative evaluation and early mobilization. After 5 days, Mrs. Chompsky was transferred from acute care to the hospital’s inpatient rehabilitation unit for a 6-week stay. She received 4 hours of therapy a day from speech-language pathology, occupational and physical therapy, psychology, and social work. She also was able to access a bowel and bladder nurse and a rehabilitation physician. In the last 2 weeks of her rehabilitation stay, she and her team were focused on planning her discharge, including needed equipment and health and social services. Mrs. Chompsky hopes that although she is much slower than before, she will be able to go home to do some of the things that bring her joy and purpose, like knitting for charity and tending her plants.
Provocative Questions
Thinking about Mrs. Chompsky, what are some reasons ...