Biomedical Engineering Reference
In-Depth Information
is a clear concept, there are different definitions in the medical literature that emphasize
different aspects. However, they are unanimous in considering frailty as a condition of
multifactorial global functional decline that can easily lead to disability. This chapter fol-
lows the ICF definition of disability from the perspective of the biopsychosocial model
outlines. This emphasizes that personal factors, environmental conditions, and the health
of the individual merge to define the disability status.
The management of an elderly patient requires an approach that takes into account all
of the factors that can affect health (illness, functional status, psychosocial situation, and
environmental conditions). This procedure is called the comprehensive geriatric assessment
(CGA) and is characterized by a multiprofessional team working with the objective of
establishing priorities for the individualized plan of care. This chapter provides a detailed
description of the procedure underlining the validity of this approach in the management
of an elderly patient.
A care plan also provides rehabilitative treatments: in this chapter the clinical course
of geriatric rehabilitation is described, emphasizing the importance of first performing
a screening assessment of the patient, multidisciplinary interventions, and continuity of
care. Assistive solutions can offer an important contribution to the practice of geriatric
rehabilitation and continuity of care.
A description of state-of-the-art applications based on intelligent technologies is
provided. Specifically, this chapter describes information and communications technology-
based assistive living solutions for the elderly with cognitive and/or motor disabilities.
Particular emphasis is given to the role that some individual factors have on technology
acceptance by older users.
The role of the geriatrician is analyzed via a case study illustrating the Matching Person
and Technology (MPT) assessment process. In a center for technical aid, the geriatrician
could collaborate as a professional consultant to support a collaborative partnership
between the service providers and the older user. A comprehensive geriatric assessment
approach combined with an ICF model offer a unique opportunity to describe and classify
functioning, disability, and health in a common framework with a universal language
(Scherer et al. 2011; Stier-Jarmer et al. 2011). Furthermore, the MPT process also contributes
to guiding the service provider in assistive technology decision-making and in the use
of evidence-based outcome measures. Adoption of the ICF in geriatric medicine and
geriatrician training in assistive solution is debated.
In conclusion, this chapter underlines the need to introduce training in assistive solutions
for health professionals and to update and promote research in this area. Moreover, health
workers need to be trained to spread the available knowledge about assistive solutions
and to understand which factors best determine the match between an older user and
technological aids. All of these factors need to take into account the ICF biopsychosocial
framework (Arthanat and Lenker 2004; Scherer 2005; Scherer et al. 2011).
Summary of the Chapter
Heterogeneity in the health status of elderly patients requires a particular care approach,
and geriatric medicine is the answer. To cope with, the geriatric assessment approach
guides the geriatrician into considering the interaction between functional status and
cognitive, medical, affective, environmental, social support, economic, and spirituality
