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Chapter 9: Special Topics: Geriatrics

Chris Childers; Jim Mathews

CLINICAL APPLICATION OF FOUNDATIONAL SCIENCES

In 2011, the Federation of State Boards of Physical Therapy (FSBPT) issued a conservative estimate that older adults (ages 65−85) accounted for 40% of all physical therapy services and contributed to both the large growth in the profession1,2 and the projected future shortages of physical therapists (Figure 9–1). In addition, the old-old were, and continue to be, the fastest growing component age group in the United States.3

FIGURE 9–1

Physical therapist supply and demand. 2016 Projections using attrition rate of 3.5%. FTE, full-time employees.

A dot-and-line graph shows increase in supply of FTEs and demand.
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High-Yield Terms to Learn

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Ageism Age discrimination; occurs when bias is the primary motivation behind acts against a person or group.
Agnosia Failure to recognize or identify objects despite intact sensory function.
Apraxia Impaired ability of previously learned motor activities yet intact motor function.
Component age groups

Chronological age is defined as age in years, and is therefore easily determined. For convenience and simplicity, the following terms are used for the component age groups:

  • Middle-age: 45 to 64 years

  • Young-old: 65 to 74 years

  • Old: 75 to 84 years

  • Old-old: 85 to 99 years

  • Oldest-old: 100+ years
Concreteness Recognizing concrete concepts but not abstract concepts or words.
Dementia-related memory loss Initially short-term with progression to include long-term memory.
Durable power of attorney for health care “Durable power” allows a patient to name a “patient advocate” to act on behalf of the patient and carry out his or her wishes.
Geriatrics The branch of medicine that focuses on health promotion and the prevention and treatment of disease and disability in later life.
Gerontology The study of the aging process and the science related to the care of the elderly.
Life expectancy Life expectancy, the number of years an individual can expect to live, is based on average life spans. Men generally have lower life expectancy rates than women at every age.
Life span

Maximum life span: the greatest age attainable by any member of a species.

Average life span: the average age reached by members of a population. This figure has shown changes over time, largely due to medical advances. The average life span was 47 years in 1900 and 75 years in 1990. As of the year 2017, in the United States the life expectancy for females was 81 years. For males the comparable figure was 77.
Living will A living will allows a patient to state his or her wishes in writing but does not name a patient advocate.
Morbidity

Morbidity (from Latin morbidus: sick, unhealthy) refers to the number of people who have a disease (prevalence) as compared to the total number of people in a population at a particular point in time. The term morbidity can also refer to:

  • The state of being diseased

  • The degree or severity ...

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