Biomedical Engineering Reference
In-Depth Information
13
The Geria
trician
M. Pigliautile, L. Tiberio, P. Mecocci, and S. Federici
CONTENTS
13.1 Introduction ........................................................................................................................ 269
13.2 Analysis of the Older Patient: Diseases, Disability, and Frailty .................................. 270
13.2.1 Disease ..................................................................................................................... 270
13.2.2 Disability ................................................................................................................. 271
13.2.3 Frailty ....................................................................................................................... 272
13.3 Geriatric Assessment ......................................................................................................... 273
13.4 Geriatric Rehabilitation ..................................................................................................... 275
13.5 Assistive Solutions: A Challenge in Geriatric Rehabilitation ...................................... 277
13.5.1 Technological Devices for Elderly People With Cognitive Impairments ...... 278
13.5.2 Technological Devices for Elderly People With Motor Disability .................. 279
13.5.3 Socially Assistive Robotics Systems .................................................................... 280
13.6 Acceptance, Rejection, or Abandonment of an Assistive Technology ....................... 281
13.7 The Role of the Geriatrician in the Assistive Technology Assessment Process ....... 282
13.8 Case Study and the ATA Process .................................................................................... 287
13.8.1 The Role of the Geriatrician in the ATA Process for the User A.B. ................ 288
13.9 Conclusions ......................................................................................................................... 291
Summary of the Chapter ............................................................................................................ 292
References ..................................................................................................................................... 293
13.1 Introduction
The word “geriatrics” was coined by Ignatz Leo Nascher (1863-1944), a Viennese man who
worked as a physician in New York and who claimed that aging is not a disease but a
period of life with its own physiology, requiring the need to treat geriatric medicine as
a separate entity, as is done for pediatrics (Achenbaum 1995; Morley 2004). In the 1930s,
Marjory Warren developed the principles of modern geriatric medicine in the United
Kingdom by enhancing the environment, introducing active rehabilitation programs, and
emphasizing the importance of the older person's motivation (Morley 2004).
Over time, geriatric medicine developed core values, a knowledge base, and clinical skills
to improve the health, functioning, and well-being of older people and to afford appropri-
ate palliative care, for which a marked expansion over the past three decades occurred
to meet the growing needs for care of the aging population (American Geriatrics Society
Core Writing Group of the Task Force on the Future of Geriatric Medicine 2005). In fact,
the U.S. Census Bureau data (Kinsella and He 2009) reports an extraordinary demographic
and epidemiological change that can be seen as a success story for public health policies
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