After completion of this chapter, the physical therapist should be able to do the following:
Rehabilitative care of older adults has evolved into a specialty area of practice for many clinicians. Geriatrics, or the care of the older adult, is based on the recognition that the aging process causes the body to respond differently to activity, injury, disease, and medical care than when it was younger. The field of geriatrics continues to gain attention as a result of the rapid growth of this segment of the population and its predicted socioeconomic impact in the present century.
Traditionally, demographers have used the age of 65 years to delineate an individual reaching “old age.” Reasons for this delineation include established social practices, such as retirement from work, and eligibility for benefits such as Social Security and Medicare. This segment of the population is growing steadily, both in absolute numbers and in proportion to the total population.1 A tremendous increase in the number of individuals reaching “old age” is projected to occur during the next 40 to 50 years. In 1900, there were 3 million people aged 65 years and older in the United States, representing 4% of the total population. In 1988, the number of people aged 65 years and older grew to 31.6 million or 12.7% of the total population.2 It is estimated that in 2030, more than 70 million individuals will be older than the age of 65 years, representing nearly 20% of the population.3 This dramatic growth is a result of the large cohorts born during the post–World War II “baby boom” that will be reaching old age, and the improved survivorship in all age cohorts, especially those regarded as the oldest-old at 85 years. The number of older adults aged 85 years or older is predicted to triple in number by 2040.4 Since the mid-19th century, life expectancy in the United States has nearly doubled, from 40 years to almost 80 years,5 because of both medical and scientific breakthroughs and improved health habits. However, for the first time in history, life expectancy at birth has the potential to decline as a result of the effects of widespread, chronic diseases associated with obesity.6 Thus, the United States may be faced with ...