Recreational Therapy: An IntroductionChapter 9: Geriatric Practice

PowerPoint Slides

Growing aging population in the U.S.

There are approximately 89 million Americans aged 65 and older.

This population more than doubled the number of aging persons in the U.S. in 2010.

Rapid projected increase in U.S. aging population

Growing aging population in Canada

By 2031, a projected 9 million Canadians will be over age 65.

This will be 25% of Canada’s population, almost double today’s aging population of 13%.

Ageism

The term ageism was coined by Robert Butler, a geriatrician, to describe the “prejudice and discrimination against older adults.”

(Ferrini & Ferrini, 2013, p. 6)

Geriatrics

Geriatrics is the study of “health and disease in later life; the comprehensive health care of older persons; and the well-being of their informal caregivers.”

(Association for Gerontology in Higher Education, 2006)

Gerontology

Gerontology is the study of the aging process and individuals as they grow from midlife through later life, including the study of physical, mental and social changes; the investigation of the changes in society resulting from our aging population; the allocation of the knowledge to policies, programs, and practice. As a result of the multidisciplinary focus of gerontology, professionals from diverse fields call themselves gerontologists.

(Association for Gerontology in Higher Education, 2006)

Continuum of older adults

Young-old (65-74)

Old-old (75-85)

Oldest of the old (85+)

Chronic conditions and older adults

Chronic conditions are especially prevalent among older adults.

For persons over age 65, 90% have a chronic condition, and 77% have two or more chronic conditions.

The focus of treatment is managing the chronic illness by reducing symptoms.

Dementia

Dementia is a cognitive disorder that affects 5.5 Americans.

It is a progressive brain impairment that interferes with memory and typical intellectual functioning.

The problems are severe enough that they interfere with the ability to perform activities of daily living.

According to the Alzheimer’s Association, “the symptoms of dementia may vary, but two of the following core mental functions must be significantly impaired to be considered dementia: (a) memory, (b) communication and language, (c) ability to focus and pay attention, (d) reasoning and judgment, and (f) visual perception.”

Alzheimer’s disease

Alzheimer’s disease is the most common type of dementia and accounts for 60% to 80% of all dementias.

Roles of RTs in geriatric care

Expert clinician

Trainer and educator

Consumer of evidence

Supervisor and manager

Clinical practice guidelines for geriatric RT

Dementia Practice Guidelines for Recreational Therapy (Buettner & Fitzsimmons, 2013)

Recreational Therapy for the Treatment of Depression in Older Adults: A Clinical Practice Guideline (Buettner, Cummins et al., 2008)

Research examples: The efficacy of RT in geriatrics

Older adults with chronic conditions benefited from physical activity by displaying significant increases in physical performance and functional mobility.

Persons with dementia who received RT significantly decreased depression, agitation, apathy, and passivity and increased self-efficacy.

Setting for RT geriatric care:

Home care

Medical home

Adult day services

Continuous care retirement communities

Assisted living facilities

Nursing homes

Hospitals