Geriatric rehabilitation ('alters-rehabilitation') - The new challenge for social medicine and science

The great new demands created by the increasing average age of our population are by medicine in general, social medicine and the science of rehabilitation medicine in a broad sense not yet addressed and perhaps not even recognized in their respective fields. The older people get, the larger becomes the grey zone between the 'pathology' and 'physiology' of old age. There are also specific diseases which are over-represented in older age groups. It is illogical as well as inhuman to expend large amounts of effort and money on acute medicine and then leave the survivors without help to optimize their quality of life further. However, both the rehabilitationist and the rehabilitees must accept their responsibility to society, in the way of economic feasibility, otherwise an increasing need for rehabilitation will become unbearable. Responsible scientific evaluation must become one of the most important factors in this field, together with a well-defined rehabilitation science and the increasing presence of rehabilitation in medical education. Our main practical postulate for geriatric rehabilitation is to be holistic and permanent. This includes a fluent transition from the acute phase to the rehabilitation phase under one specialist's care and in one institution. We could show that the main useful instruments for this are mixed age groups in one ward (in contrast to isolated 'senior ghettos'), systematic education of relatives and a follow-up rehabilitation service, and a complex and concerted rehabilitation group including integrated psychotherapy. Overlapping of geriatric and nursing sciences should not be opposed by terminological and professional disputes. The same counts for the motivation of the institutions responsible for the costs. This should not be a discussion on costs, or on professional prestige. What we want is rational distribution of the resources available. Only such a viewpoint can be adequate to a medicine that wants to call itself 'human'.