Moderation: C. Becker, Stuttgart
There is now strong evidence that rehabilitation programs can be effective for older people. This presentation aims to provide a synthesis of the evidence of effi cacy and effectiveness of these programs. Multiple systematic reviews and meta-analyses show that rehabilitation for older people (“geriatric rehabilitation”) can be effective. This has been established with reference to stroke, hip fracture and falls prevention. There is developing evidence that rehabilitation in frailty is also effective. However, health services research about rehabilitation and older people has lagged behind effectiveness research. As a result it is generally more diffi cult to establish its optimal setting, particularly whether to provide the rehabilitation as a hospital inpatient or in a clinic or in the community, or in another setting (for example in a nursing care facility). There is considerable variability in models for rehabilitation service provision between countries. It is concluded that, if the rehabilitation program can be provided in a community setting it appears at least as effective as an inpatient program. Nursing care facility programs have the potential to worsen outcomes by prolonging disability and dependency. Conclusions: The goal should be to provide geriatric rehabilitation programs in the setting with the optimal benefi t to the older person and also optimal cost effectiveness. In many situations this will be in a community rather than hospital setting.
Prof. Ian Cameron
Ian Cameron is a Consultant Physician in Rehabilitation Medicine and has the Chair in Rehabilitation Medicine, Sydney Medical School, at the University of Sydney. He is a clinician researcher and holds a National Health and Medical Research Council Practitioner Fellowship.