Geriatric Rehabilitation

  • Joan C. Rogers
  • Margo B. Holm
Part of the Human Brain Function book series (HBFA)


The role of geriatric rehabilitation in health care is to manage the residual effects of medical, psychiatric, and age-associated pathologies rather than the pathologies themselves. Rehabilitation begins with a functional assessment, that is, with measuring how pathology influences an older adult’s ability to function. Historically, there has been substantial confusion about the meaning of the term function. It has been applied to body organs or systems, as in muscle function; body parts, as in the function of the upper extremity; task performance, as in eating functions; or role performance, as in homemaker functions. This lack of clarity about the meaning of function has obscured the role of rehabilitation and the focus of the functional assessment.


Task Performance Barthel Index Geriatric Depression Scale Functional Independence Measure American Geriatrics Society 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Anthony, J. C., Le Resche, L., Niaz, U., Van Koff, M. R., and Folstein, M. (1982). Limits of the “Mini-Mental State” as a screening test for dementia and delirium among hospital patients. Psychological Medicine, 12, 397–408.Google Scholar
  2. Bakeman, R., and Gottman, J. M. (1986). Observing interaction: An introduction to sequential analysis. Cambridge, England: Cambridge University Press.Google Scholar
  3. Brink, T. L., Yesavage, J. A., Owen, L., Heersema, P. H., Adey, M., and Rose, T. L. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1, 37–43.CrossRefGoogle Scholar
  4. Brink, T. L., Curran, P., Dorr, M. L., Janson, E., McNulty, U., and Messina, M. (1985). Geriatric Depression Scale reliability: Order, examiner, and reminiscence effects: A critical review. Clinical Gerontologist, 3, 57-59.Google Scholar
  5. Brorsson, B., and Asberg, K. H. (1984). Katz Index of Independence in ADL: Reliability and validity in short-term care. Scandinavian Journal of Rehabilitation Medicine, 16, 125–132.PubMedGoogle Scholar
  6. Byrnes, M. B., and Powers, F. F. (1989). FIM: Its use in identifying rehabilitation needs in the head-injured patient. Journal of Neuroscience Nursing, 21, 61–63.Google Scholar
  7. Cole, B., Finch, E., Gowland, C., and Mayo, N. (1994). Physical rehabilitation outcome measures. Toronto, Ontario, Canada: Canadian Physiotherapy Association.Google Scholar
  8. Collin, C., Wade, D. T., Davis, S., and Home, V. (1988). The Barthel Index: A reliability study. International Disability Studies, 10, 61–63.Google Scholar
  9. Czyrny, J., Hamilton, B. B., Sc Gresham, G. E. (1990). Rehabilitation of the stroke patient. In M. G. Eisenberg and R. C. Grzesiak (Eds.) Advances in Clinical Rehabilitation (pp. 64–96). New York: Springer.Google Scholar
  10. Davidoff, G. N., Roth, E. J., Haughton, J. S., and Ardner, M. S. (1990). Cognitive dysfunction in spinal cord injury patients: Sensitivity of the functional independence subscales vs. neuropsychological assessment. Archives of Physical Medicine and Rehabilitation, 71, 326–329.PubMedGoogle Scholar
  11. Duncan, P. W., Weiner, D. K., Chandler, J., and Studenski, S. (1990). Functional reach: A new clinical measure of balance. Journal of Gerontology: Medical Sciences, 45, M192 - M197.Google Scholar
  12. Duncan, P. W., Studenski, S., Chandler, J., and Prescott, B. (1992). Functional reach: Predictive validity in a sample of elderly male veterans. Journal of Gerontology: Medical Sciences, 47, M93 - M98.Google Scholar
  13. Erber, N. A. (1992). An adaptive screening of sentence perception in older adults. Ear and Hearing, 13, 58–60.PubMedCrossRefGoogle Scholar
  14. Erkinjuntti, T., Sulkava, R., Wikstrom, J., and Autio, L. (1987). Short Portable Mental Status Questionnaire as a screening test for dementia and delirium among the elderly. Journal of the American Geriatric Society, 35, 412–416.Google Scholar
  15. Ernst, M., Sc Ernst, N. S. (1984). Functional capacity. In D. J. Mangen and W. A. Peterson (Eds.), Researchinstruments in gerontology (Vol. 3, pp. 9–84). Minneapolis: University of Minnesota Press.Google Scholar
  16. Fillenbaum, G. (1980). Comparison of two brief tests of organic brain impairment, the MSQ and the Short Portable MSQ. Journal of the American Geriatrics Society, 28, 381–384.PubMedGoogle Scholar
  17. Fillenbaum, G. G. (1988). Multidimensional functional assessment of older adults: The Duke older Americans resources and services procedures. Hillsdale, NJ: Erlbaum.Google Scholar
  18. Fitti, J. E, and Kovar, M. G. (1987). The supplement on aging to the 1984 national health interview survey. Vital and health statistics, Series 1, No. 21. DHHS Publication No. PHS 87–1323. Washington, DC: Public Health Services.Google Scholar
  19. Folstein, M. F., Folstein, S. E., and McHugh, P. R. (1975). “Mini-Mental State,” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.PubMedCrossRefGoogle Scholar
  20. Gerrity, M. S., Gaylord, S., and Williams, M. E. (1993). Short versions of the Timed Manual Performance Test: Development, reliability, and validity. Medical Care, 31, 617–628.PubMedCrossRefGoogle Scholar
  21. Granger, C. (1987). The Functional Independence Measure. Buffalo: Research Foundation of the State University of New York.Google Scholar
  22. Granger, C. V., and Greer, D. A. (1976). Functional status measurement and medical rehabilitation outcomes. Archives of Physical Medicine and Rehabilitation, 57, 103–108.PubMedGoogle Scholar
  23. Granger, C. V., Sherwood, C. C., and Greer, D. S. (1977). Functional status measures in a comprehensive care program. Archives of Physical Medicine and Rehabilitation, 58, 555–561.PubMedGoogle Scholar
  24. Granger, C. V., Albrecht, G. L., and Hamilton, B. B. (1979). Outcome of comprehensive and medical rehabilitation: Measurement by the PULSES Profile and the Barthel Index. Archives of Physical Medicine and Rehabilitation, 60, 145–154.Google Scholar
  25. Granger, C. V., Seltzer, G. B., and Fishbein, C. F. (1987). Primary care of the functionally disabled: Assessment and management. Philadelphia: Lippincott.Google Scholar
  26. Gresham, G. E., Phillips, T. F., and Labi, M. L. C. (1980). ADL status in stroke: Relative merits of three standard indexes. Archives of Physical Medicine and Rehabilitation, 61, 355–358.PubMedGoogle Scholar
  27. Hamilton, B. B., and Granger, C. V. (1991). A rehabilitation uniform data system. (Research Grant Rep. No. G008435062 ). Buffalo: State University of New York, UDS Data Management Service.Google Scholar
  28. Hamilton, B. B., Granger, C. V., Sherwin, F. S., Zielezny, M., and Tashman, J. S. (1987). A uniform national data system for medical rehabilitation. In M. J. Fuhrer (Ed.), Rehabilitation outcomes: Analysis and measurement (pp. 137–147 ). Baltimore: Brooks.Google Scholar
  29. Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296.PubMedCrossRefGoogle Scholar
  30. Haworth, R. J., and Hollings, E. M. (1979). Are hospital assessments of daily living activities valid? International Rehabilitation Medicine, 1, 59–62.Google Scholar
  31. Heinemann, A. W., Linacre, J. M., Wright, B. D., Hamilton, B. B., and Granger, C. (1994). Prediction of rehabilitation outcomes with disability measures. Archives of Physical Medicine and Rehabilitation, 75, 133–143.PubMedCrossRefGoogle Scholar
  32. Jaworski, D. M., Kult, T., and Boynton, P. R. ( 1994, Winter). The Functional Independence Measure: A pilot study comparison of observed and reported ratings. Rehabilitation Nursing Research, 141–147.Google Scholar
  33. Jebsen, R. H., Taylor, N., Trieschmann, R. B., Trotter, M. J., and Howard, L. A. (1969). An objective and standardized test of hand function. Archives of Physical Medicine and Rehabilitation, 50, 311–319.PubMedGoogle Scholar
  34. Jette, A. M. (1987). The Functional Status Index: Reliability and validity of a self-report functional disability measure. Journal of Rheumatology, 14 (Suppl. 15), 15–19.PubMedGoogle Scholar
  35. Kahn, R. L., Zarit, S. H., Hilbert, N. M., and Niederehe, G. (1975). Memory complaint and impairment in the aged. Archives of General Psychiatry, 32, 1569–1573.PubMedCrossRefGoogle Scholar
  36. Kane, R. A., and Kane, R. L. (1981). Assessing the elderly. Lexington, MA: Lexington Books.Google Scholar
  37. Kane, R. L., Saslow, M. G., and Brundage, T. (1991). Using ADLs to establish eligibility for long-term care among cognitively impaired. Gerontologist, 31, 60–66.Google Scholar
  38. Katz, S., and Akpom, C. A. (1976). Index of ADL. Medical Care, 14, 116–118.Google Scholar
  39. Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., and Jaffe, M. W. (1963). Studies of illness in the aged. The Index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914–919.PubMedCrossRefGoogle Scholar
  40. Katz, S., Downs, T. D., Cash, H. R., and Grotz, R. C. (1970). Progress in development of the Index of ADL. Gerontologist, 10, 20–30.Google Scholar
  41. Lawton, M. P., and Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.PubMedCrossRefGoogle Scholar
  42. Lewis, C. B. (1994). Clinical measures of functional outcomes “The functional toolbox. ”Washington, DC: Learn.Google Scholar
  43. Linacre, J. M., Heinemann, A. W., Wright, B. D., Granger, C. V., and Hamilton, B. B. (1994). The structure and stability of the Functional Independence Measure. Archives of Physical Medicine and Rehabilitation, 75, 127–132.PubMedGoogle Scholar
  44. Loewenstein, D. A., Amigo, E., Duara, R., Guterman, A., Hurwitz, D., Berkowitz, N., Wilkie, F., Weinberg, G., Black, B., Gittelman, B., and Eisdorfer, C. (1989). A new scale for the assessment of functional status in Alzheimer’s disease and related disorders. Journal of Gerontology: Psychological Sciences, 44, P114 - P121.Google Scholar
  45. Long, W. B., Sacco, W. J., Coombes, S. S., Copes, W. S., Bullock, A., and Melville, J. K. (1994). Determining normative standards for the Functional Independence Measure transitions in rehabilitation. Archives of Physical Medicine and Rehabilitation, 75, 144–148.PubMedGoogle Scholar
  46. Mahoney, F. I., and Barthel, D. W. (1965). Functional evaluation-The Barthel Index. Maryland State Medical Journal, 14, 61–65.PubMedGoogle Scholar
  47. Mahurin, R. K., DeBettignies, B. H., and Pirozzolo, F. J. (1991). Structured assessment of independent living skills: Preliminary functional abilities in dementia. Journal of Gerontology: Psychological Sciences, 46, P58 - P66.Google Scholar
  48. McDowell, I., and Newell, C. (1987). Measuring health: A guide to rating scales and questionnaires. New York: Oxford University Press.Google Scholar
  49. McGinnis, G. E., Marymae, B. A., Seward, B. A., DeJong, G., and Osberg, J. S. (1986). Program evaluation of physical medicine and rehabilitation departments using self-report Barthel. Archives of Physical Medicine and Rehabilitation, 67, 123–125.Google Scholar
  50. Merbitz, C., Morris, J., and Grip, J. C. (1989). Ordinal scales and foundations of misinference. Archives of Physical Medicine and Rehabilitation, 70, 308–312.PubMedGoogle Scholar
  51. Morris, J. N., Hawes, C., Murphy, K., Nonemaker, S., Phillips, C., Fries, B. E., and Mor, V. (1991). Resident Assessment Instrument training manual and resource guide. Natick, MA: Eliot.Google Scholar
  52. Nagi, S. Z. (1969). Disability and rehabilitation. Columbus, OH: Ohio State University Press.Google Scholar
  53. Ostwald, S. K., Snowdown, D. A., Rysavy, S. D. M., Keenan, N. L., and Kane, R. L. (1989). Manual dexterity as a correlate of dependency in the elderly. Journal of the American Geriatrics Society, 37, 963–969.PubMedGoogle Scholar
  54. Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23, 433–441.PubMedGoogle Scholar
  55. Radloff, L. S. (1977). The CES-D Scale: A new self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  56. Reisberg, B., Ferris, S. H., de Leon, M. J. and Crook, T. (1982). The Global Deterioration Scale for as- sessment of primary degenerative dementia. American Journal of Psychiatry, 139, 1136–1139.Google Scholar
  57. Reisberg, B., London, E., Ferris, S. H., Borenstein, J., Scheier, L., and de Leon, M. J. (1983). The Brief Cognitive Rating Scale: Language, motoric, and mood concomitants in primary degenerative dementia. Psychopharmacology Bulletin, 19, 702–708.Google Scholar
  58. Reisberg, B., Ferris, S. H., Anand, R., de Leon, M. J., Schneck, M. K., Buttinger, C., and Borenstein, J. (1984). Functional staging of dementia of the Alzheimer’s type, Annals of the New York Academy of Science, 435, 481–483.CrossRefGoogle Scholar
  59. Roccaforte, W. H., Burke, W. J., Bayer, B. L., and Wengel, S. P. (1992). Validation of a telephone version of the Mini-Mental State Examination. Journal of the American Geriatrics Society, 40, 697–702.PubMedGoogle Scholar
  60. Rogers, J. C. (1989). The occupational therapy home assessment: The home as a therapeutic environment. Journal of Home Health Care Practice, 1, 73–81.CrossRefGoogle Scholar
  61. Rogers, J. C., Holm, M. B., Goldstein, G., and Nussbaum, P. D. (1994). Stability and change in functional assessment of patients with geropsychiatric disorders. AmericanJournal of Occupational Therapy, 48, 914–918.Google Scholar
  62. Roy, C. W., Togneri, J., Hay, E., and Pentland, B. (1988). An inter-rater reliability study of the Barthel Index. International Journal of Rehabilitation Research, 11, 67–70.Google Scholar
  63. Rubenstein, L., Schairer, C., Wieland, G. D., and Kane, R. (1984). Systematic biases in functional status assessment of elderly adults: Effects of different data sources. Journal of Gerontology, 39, 686–691.PubMedCrossRefGoogle Scholar
  64. Scholer, S. G., Potter, J. F., and Burke, W. J. (1990). Does the Williams Manual Test predict service use among subjects undergoing geriatric assessment? Journal of the American Geriatrics Society, 38, 767–772.PubMedGoogle Scholar
  65. Sclan, S., and Reisberg, B. (1992). Functional Assessment Staging (FAST) in Alzheimer’s disease: Reliability, validity, and ordinality. International Psychogeriatrics, 4 (Suppl. 1), 55–69.PubMedCrossRefGoogle Scholar
  66. Sheikh, J. I., and Yesavage, J. A. (1986). Geriatric Depression Scale (GDS) recent evidence and development of a shorter version. In T. L. Brink (Ed.), Clinical gerontology: A guide to assessment and intervention (pp. 165–173 ). New York: Haworth.Google Scholar
  67. Shinar, D., Gross, C. R., Bronstein, K. S., Licata-Gehr, E. E., Eden, D. T., Cabera, A. R., Fishman, I. G., Roth, A. A., Barwick, J. A., and Kunitz, S. C. (1987). Reliability of the activities of daily living scale and its use in telephone interview. Archives of Physical Medicine and Rehabilitation, 68, 723–728.PubMedGoogle Scholar
  68. Smyer, M. A., Hofland, B. F., and Jonas, E. A. (1979). Validity study of the Short Portable Mental Questionnaire for the elderly. Journal of the American Geriatrics Society, 27, 263–269.Google Scholar
  69. Steinberg, E. P., Tielsch, J. M., Schein, O. D., Javitt, J. C., Sharkey, P., Cassard, S. D., Legro, M. W., Diener-West, M., Bass, E. B., Damiano, A. M., Steinwachs, D. M., and Sommer, A. (1994). The VF-14: An index of functional impairment in patients with cataract. Archives of Ophthalmology, 112, 630–638.PubMedCrossRefGoogle Scholar
  70. Tinetti, M. E. (1986). Performance oriented assessment of mobility problems in elderly patients. Journal of the American Geriatrics Society, 34, 119–126.PubMedGoogle Scholar
  71. Tinetti, M. E., Speechley, M., and Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319, 1701–1707.PubMedCrossRefGoogle Scholar
  72. Tombaugh, T. N., and McIntyre, N. J. (1992). The Mini-Mental State Examination: A comprehensive review. Journal of the American Geriatrics Society, 40, 922–935.Google Scholar
  73. Travis, S. S., and McAuley, W. J. (1990). Simple counts of the number of basic ADL dependencies for long-term care research and practice. Health Services Research, 25, 349–360.PubMedGoogle Scholar
  74. Tsai, L., and Tsang, M. T. (1979). The Mini-Mental State Test and computerized tomography. American Journal of Psychiatry, 136, 436–439.PubMedGoogle Scholar
  75. Uzgiris, I., and Hunt, J. McV. (1975). Assessment in infancy: Ordinal Scales of Psychological Development. Urbana: University of Illinois.Google Scholar
  76. Weiner, D., Bongiorni, D., Kochersberger, G., Duncan, P., and Studenski, S. (1991). Does functional reach improve with rehabilitation? (Abstract). Journal of the American Geriatrics Society, 39, A10.Google Scholar
  77. Weiner, D. K., Duncan, P. W., Chandler, J., and Studenski, S. A. (1992). Functional reach: A marker of physical frailty. Journal of the American Geriatrics Society, 40, 203–207.PubMedGoogle Scholar
  78. Weissmann, M., Myers, J. K., and Tischler, G. L. (1985). Psychiatric disorders (DSM-III) and cognitive impairment among the elderly in a U.S. urban community. Acta Psychiatrica Scandinavica, 71, 366–369.CrossRefGoogle Scholar
  79. Williams, M. E. (1987). Identifying the older person likely to require long-term care services. Journal of the American Geriatrics Society, 35, 761–766.Google Scholar
  80. Williams, M. E., and Hornberger, J. C. (1984). A quantitative method of identifying older persons at risk for increasing long-term care services. Journal of Chronic Disease, 37, 705–711.CrossRefGoogle Scholar
  81. Williams, M. E., Hadler, N. M., and Earp, J. A. L. (1982). Manual ability as a marker of dependency in geriatric women. Journal of Chronic Diseases, 35, 115–122.PubMedCrossRefGoogle Scholar
  82. Williams, M. E., Gaylord, S. A., and Gerrity, M. S. (1994). The Timed Manual Performance Test as a predictor of hospitalization and death in a community-based elderly population. Journal of the American Geriatric Society, 42, 21–27.Google Scholar
  83. Wood, P. H. N. (1975). Classification of impairments and handicaps. Document WHO/ICDO/REVCONF/75. 15. Geneva, Switzerland: World Health Organization.Google Scholar
  84. World Health Organization. (1980). The international classification of impairments, disabilities, and handicaps.’ Geneva, Switzerland: World Health Organization.Google Scholar
  85. Wylie, C. M., and White, B. K. (1964). A measure of disability. Archives of Environmental Health, 8, 834–939.PubMedGoogle Scholar
  86. Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., and Leirer, O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar
  87. Zung, W. W. K. (1965). A self-rated depression scale. Archives of General Psychiatry, 12, 63–70.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Joan C. Rogers
    • 1
  • Margo B. Holm
    • 2
  1. 1.Western Psychiatric Institute and ClinicPittsburghUSA
  2. 2.Occupational Therapy ProgramCollege MisericordiaDallasUSA

Personalised recommendations