MANAGEMENT OF FUNCTIONAL IMPAIRMENT IN THE ELDERLY
“Functional status” may be briefly described as the personal ability to manipulate the environment and to perform self-care. The World Health Organisation stated that health in the elderly is best measured in terms of function. The purpose of this paper is to discuss management of functional losses of the elderly in the primary care setting. Two kinds of scales are being used to evaluate the functional status: One of them, named “activities of daily living ” assesses the ability to perform self-care, the other; “instrumental activities of daily living” assesses the ability to manipulate the environment. Beside classical medical history and physical examination, areas closely related to functional status should be checked out while dealing with elderly: Mobility and balance, history of previous falls, range of motion; (especially of the shoulders and hands), vision and hearing, nutritional status, urinary incontinence, medications and mental health status. Detected problems in any of these areas should be managed immediately. While evaluating the elderly it may be helpful to keep in mind two facts: -The elderly may experience many emotional losses besides the functional ones; -they frequently do not report them as accepting that these are “natural” or “consequences of aging”.