Discuss appropriate referrals and consultations for the adult-geriatric patient experiencing acute or chronic immobility. Differentiate the requirements for acute rehabilitation, skilled care (transitional care), long-term care, and hospice patients who are preparing for discharge from the acute care setting and may require bridge therapy to increase strength, balance, and conditioning prior to transitioning to a safe independent living environment. Discuss general admission criteria, including number of modalities of therapy, number of hours of therapy per day in which the patient must participate, and any restrictions such as renal dialysis. Identify at least one restorative level of care that an acute care adult-geriatric patient can be transferred to as a bridge to independent living and briefly describe the criteria for admission (e.g., number of hours of therapy and number of different modalities of therapy–speech, PT, OT, skilled nursing) within skilled or transitional care, home health, acute rehabilitation, long-term acute care, hospice, or other.
Discuss appropriate referrals and consultations for the adult-geriatric patient experiencing acute or chronic immobility. Differentiate the requirements for acute rehabilitation, skilled care (transitional care), long-term care, and hospice patients who are preparing for discharge from the acute care setting and may require bridge therapy to increase strength, balance, and conditioning prior to transitioning to a safe independent living environment. Discuss general admission criteria, including number of modalities of therapy, number of hours of therapy per day in which the patient must participate, and any restrictions such as renal dialysis. Identify at least one restorative level of care that an acute care adult-geriatric patient can be transferred to as a bridge to independent living and briefly describe the criteria for admission (e.g., number of hours of therapy and number of different modalities of therapy–speech, PT, OT, skilled nursing) within skilled or transitional care, home health, acute rehabilitation, long-term acute care, hospice, or other.
DQ question
A geriatric patient with acute or chronic immobility should be referred to a dietitian to assess their nutritional status and offer dietary recommendations. They are referred to a physical and occupational therapist for mobility and gait assessment, assessment of physical functioning, and assessing the need for ADL devices. Requirements for acute rehabilitation include a patient who can participate in an intensive therapy program for 3 hours per day, 5 -6 days per week. Skilled care requires medically stable patients who need care services provided by a licensed professional. Long-term care requirements include patients with more than one serious condition but will improve with time and care (Forrest et al., 2019). Furthermore, patients are eligible for hospice care when their physician makes a clinical determination that life expectancy is six months or less if the terminal illness runs its normal course.
An acute-care geriatric patient can be transferred to an acute rehabilitation facility. Criteria for admission include: The patient is sufficiently medically stable; Requires an intensive interdisciplinary approach to rehabilitation; Can progress and demonstrate measurable gains from skilled therapy; Able to tolerate intensive therapy; Requires daily physician management; Requires 24-hour rehab nursing care; Able and willing to participate in the program (Forrest et al., 2019). Acute rehabilitation entails intensive therapy of hours per day, 5-6 days per week.
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Discuss appropriate referrals and consultations for the adult-geriatric patient experiencing acute or chronic immobility. Differentiate the requirements for acute rehabilitation, skilled care (transitional care), long-term care, and hospice patients who are preparing for discharge from the acute care setting and may require bridge therapy to increase strength, balance, and conditioning prior to transitioning to a safe independent living environment. Discuss general admission criteria, including number of modalities of therapy, number of hours of therapy per day in which the patient must participate, and any restrictions such as renal dialysis. Identify at least one restorative level of care that an acute care adult-geriatric patient can be transferred to as a bridge to independent living and briefly describe the criteria for admission (e.g., number of hours of therapy and number of different modalities of therapy–speech, PT, OT, skilled nursing) within skilled or transitional care, home health, acute rehabilitation, long-term acute care, hospice, or other.
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Disuse osteoporosis is a common immobility disorder. It is characterized by bone loss secondary to local skeletal unloading or systemic immobilization. Disuse osteoporosis occurs when a patient cannot put weight on the bones, which causes them to lose density and become weak. It occurs mainly in patients on extended bed rest, paralyzed from an injury, or wearing a cast. Disuse accelerates bone resorption, making the bone atrophic and fragile. Diagnostic tests include Plain X-ray, Dual-energy X-ray absorptiometry, and CT scan (Rolvien & Amling, 2022). Management for disuse osteoporosis includes calcium supplements and an exercise program to improve bone density. Electrical stimulation builds and strengthens the muscles surrounding the damaged area, which helps rebuild the bone.
References
Forrest, G., Reppel, A., Kodsi, M., & Smith, J. (2019). Inpatient rehabilitation facilities: The 3-hour rule. Medicine, 98(37), e17096. https://doi.org/10.1097/MD.0000000000017096
Rolvien, T., & Amling, M. (2022). Disuse Osteoporosis: Clinical and Mechanistic Insights. Calcified tissue international, 110(5), 592–604. https://doi.org/10.1007/s00223-021-00836-1
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Part 1
Discuss appropriate referrals and consultations for the adult-geriatric patient experiencing acute or chronic immobility. Differentiate the requirements for acute rehabilitation, skilled care (transitional care), long-term care, and hospice patients who are preparing for discharge from the acute care setting and may require bridge therapy to increase strength, balance, and conditioning prior to transitioning to a safe independent living environment. Discuss general admission criteria, including number of modalities of therapy, number of hours of therapy per day in which the patient must participate, and any restrictions such as renal dialysis. Identify at least one restorative level of care that an acute care adult-geriatric patient can be transferred to as a bridge to independent living and briefly describe the criteria for admission (e.g., number of hours of therapy and number of different modalities of therapy–speech, PT, OT, skilled nursing) within skilled or transitional care, home health, acute rehabilitation, long-term acute care, hospice, or other.
Part 2
Discuss important risk factors, etiology, presentation, assessment, diagnosis, and evidence-based therapy for common acute immobility and wound management conditions and disorders for complex acute, critical, and chronically ill adult gerontology patients. Explain the presentation, etiology, risk factors, common differential diagnosis, typical diagnostic work-up, treatment plan (based on current clinical guidelines and evidence-based therapy).
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Discuss appropriate referrals and consultations for the adult-geriatric patient experiencing acute or chronic immobility. Differentiate the requirements for acute rehabilitation, skilled care (transitional care), long-term care, and hospice patients who are preparing for discharge from the acute care setting and may require bridge therapy to increase strength, balance, and conditioning prior to transitioning to a safe independent living environment. Discuss general admission criteria, including number of modalities of therapy, number of hours of therapy per day in which the patient must participate, and any restrictions such as renal dialysis. Identify at least one restorative level of care that an acute care adult-geriatric patient can be transferred to as a bridge to independent living and briefly describe the criteria for admission (e.g., number of hours of therapy and number of different modalities of therapy–speech, PT, OT, skilled nursing) within skilled or transitional care, home health, acute rehabilitation, long-term acute care, hospice, or other.
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