Rehabilitation, ageing and community care
Rehabilitation, ageing and community care
This domain tests function-focused rehabilitation for older adults and community living. Expect questions on frailty, falls, goal setting, discharge planning, caregiver support, ageing in place and community services.
Core concepts
- Assess function and participation, not just impairments: transfers, walking, ADLs, cognition, continence, home environment and social support.
- Treat frailty as a syndrome with increased vulnerability; exercise, nutrition and medication review can modify risk.
- Use multifactorial falls assessment and intervention: strength, balance, vision, medications, home hazards and fear of falling.
- Set collaborative goals with the older person and whānau; ensure consent and realistic discharge plans.
- Know community pathways: primary care, ACC, needs assessment, home care and non-governmental organisations.
Worked example
An 82-year-old has fallen twice at home and fears falling again. You assess gait, balance, strength, cognition, medications, vision and home hazards, and involve an occupational therapist for a home visit. You prescribe progressive balance and strength work with whānau support. Reasoning: falls are multifactorial, so single interventions are weaker than a coordinated plan.
Traps
- Attributing falls to “old age” and missing modifiable factors.
- Setting goals without the patient or whānau.
- Discharging home without checking safety and support.
- Ignoring caregiver burden and cultural expectations.