REHABILITATION STAFF PERCEPTIONS OF CHARACTERISTICS OF GERIATRIC REHABILITATION PATIENTS

Objective: To determine if professionals treating older rehabilitation patients regarded them as having different characteristics than young er rehabilitation patients, to derive factors from these perceptions, and to examine the impact of the discipline of the professional and ot her factors on these perceptions. Design: Rehabilitation professionals at a random sample of facilities accredited by the Commission on Accr editation of Rehabilitation Facilities were surveyed to determine thei r level of agreement with 60 items addressing characteristics of older rehabilitation patients. The items were derived from focus groups wit h rehabilitation staff members. Participants: One thousand sixty-three rehabilitation professionals from nine disciplines (nursing, occupati onal therapy, physiatry, physical therapy, psychology, social work, sp eech pathology, therapeutic recreation, and vocational counseling) res ponded to the questionnaire and were included in the study. Results: T here was a wide range of agreement levels across the 60 items (range o f median agreement, 12.7% to 93.5%). Factor analysis resulted in six c ategories of perceptions regarding older rehabilitation patients: (1) physical limitations, (2) motivational deficits, (3) psychological dis tress/need for support, (4) maturity and positive coping skills, (5) n eed for privacy/decreased adaptability, and (6) discharge complication s. Significant differences across disciplines were found for five of s ix factors. Nurses agreed more strongly with the negative psychologica l factors (2, 3, and 5) compared to physical therapists, psychologists , and social workers. Physicians scored significantly higher than two other disciplines on the physical limitations factor. These difference s may be related to the distinct role each discipline plays in the reh abilitation process. Older professionals also scored higher on four fa ctors, likely because of personal rather than professional experience with aging. Conclusions: Treating professionals recognize differences between younger and older rehabilitation patients. Many of these perce ived differences can be viewed as variables that require more effort a nd skill on the part of the treating professional. The training of reh abilitation professionals needs to better prepare individuals from all disciplines to adapt to age-specific differences. (C) 1998 by the Ame rican Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.