INTRODUCTION

One of the distinguishing aspects of geriatrics is attention to the person's functional abilities. Rehabilitation is the process by which patients who have lost function can recover them, or adapt to the loss function to be more independent. Because independence is held in such high value by older people, rehabilitation should be seen as the foundation of good geriatric care. From a physician's perspective, rehabilitation is sometimes seen as the province of the discipline of physical medicine and rehabilitation (PM&R). However, there are many circumstances when rehabilitation interventions are provided to older people without the involvement of a PM&R specialist, and the primary care physician, geriatrician, nurse practitioner or physician assistant may be working closely with other rehabilitation team members. Hence, all providers who care for older people should have a working knowledge of rehabilitation.

Rehabilitation of older adults is increasingly applied to two populations: those who acquire a disability late in life, and more recently, those who have lived with a disability much of their lives and are now aging. The latter group includes those with spinal cord injuries, traumatic brain injury, and a variety of birth injuries and genetic causes of disability. If the trend towards lessening of disability in the older population continues, it would be expected that the group who are aging with a disability will expand.

FUNCTION AND DISABILITY

The World Health Organizations framework for health and disability is the International Classification of Functioning, Disability and Health (ICF). The ICF stresses health and functioning, rather than disability.