[Geriatric Rehabilitation Care in Germany].

Geriatric rehabilitation care serves to maintain the self-determined participation of elderly people. It contributes to reduce dependency on care, which is one of society's major challenges. The focus of its work lies on elderly patients, mostly with multiple impairments and limited reserves. These people consequently face a high risk of developing further activity limitations and participation restrictions in the context of any acute illness. This justifies the large proportion of early rehabilitation already in hospital, which forms an essential part of geriatric rehabilitation care in Germany. Its goal is to reduce or prevent any associated setbacks regarding independent living as soon and as far as possible. However, early rehabilitation cannot replace a potentially necessary further medical rehabilitation - particularly under the conditions of lump-sum compensation in the context of the DRG system. But institutions for further medical rehabilitation exist only in some of the federal states in Germany.In addition, geriatric rehabilitation services are largely provided in inpatient settings in Germany. This system to date only rarely takes advantage of the benefits of other forms of rehabilitation. For instance, outpatient geriatric rehabilitation could already be used more frequently to prevent dependency on care in cases of slowly increasing deterioration of functional health. Mobile rehabilitation, where rehabilitation patients are visited in their residential environment, could be more efficient and more sustainable for patients whose rehabilitation and participation goals can be achieved less by means of restitution of lost functions rather than by the adaptation of contextual factors and the improvement of support arrangements.