Rehabilitation of Older Patients with Rheumatic Diseases

Abstract

Little is known about rehabilitation interventions in patients with rheumatic diseases; even less is known about rehabilitation of older patients with rheumatic diseases. The majority of intervention studies refer to samples with specific rheumatic diagnoses, reporting the variable “age” in terms of means and standard deviations. Elderly patients with comorbid conditions and accumulated risk factors are often excluded from randomised controlled trials. As a consequence, when planning to apply those interventions to people of advanced age, care should be taken of age-related differences and treatment challenges. This chapter deals with insights of rheumatologic rehabilitation interventions in general and in patients of advanced age more particularly. The mainstay of the treatment of older patients with rheumatic diseases is certainly the pharmacological approach, although non-pharmacological interventions of the diseases are increasingly playing a stronger role. Important treatment goals are pain relief, the restoration and preservation of (joint) function and the maintenance of independence in everyday life. Physical, occupational and exercise therapy as well as technical aids and remedies are important keystones of non-pharmacological rehabilitation in the elderly with rheumatic diseases. Last but not least, the involvement of family members or other persons who are providing help in the living environment is fundamental for the success of the rehabilitation process—especially if the person’s self-help capacity is limited due to functional or cognitive impairment.