Able bodies and disabled bodies are all part of aging. The issue of disability for healthy individuals is not so much whether but when, and not so much which disabling event or illness but, how many and in what combination. The good news is that there are medical specialists and care teams that can champion the importance of coordination of care that includes customized, special attention to functional status and quality of life after a disabling event. This is important to know because functional status is by far the most important factor affecting quality of life and healthcare service utilization in the senior years. Physicians who specialize in Physical Medicine& Rehabilitation (PM&R) are trained to focus on the patient as a whole person and to put the medical management of a disabling event within the context of that individuals life and environment. PM&R medical specialists are also called physiatrists(fee-zy-a-trists0.Asking your care provider about rehabilitation led by a specialist in this area further opens the door to coordinated care on your behalf. By partnering or consulting with a PM&R specialist, your primary care physician, or your hospitalist, neurologist, orthopedic surgeon, trauma surgeon, neurosurgeon or home health care team can enhance the ultimate chances of you doing well quicker and more comprehensively with conditions such as stroke; rheumatoid arthritis; total hip or knee replacement; sports-related injuries; musculoskeletal sprains and pain; neurological diagnoses such as multiple sclerosis, spinal cord injury, and traumatic brain injury; as well as debility that can develop after being in the hospital with a prolonged critical illness. Asking for a referral to a physiatrist can be a priceless form of self-advocacy, since, even today, there remain many physicians, care managers, and home health care providers who are not familiar with the expertise available in the field of PM&R. This article was submitted by Indira S. Lanig MD, Medical Director at Northern Colorado Rehabilitation Hospital, in Johnstown, CO. The NCRH team of physicians and therapists can be reached at 970-619-3454.

Although mobility devices can transform an individuals life and give them back some sense of independence and control, they have the potential for injury. Often, the cause is not malfunction, but rather the fact that many individuals choose the wrong device for their needs or use them incorrectly.Consider the following before choosing a mobility device:FIRST, shop for the health care provider that is the right fit for the individuals needs.CANES AND WALKERSConsider the following in choosing the right canes and walkers:How is the individuals balance?Do they have the sensation and strength in their hands to hold the device?Make sure the device is the proper height.Perform routine maintenance checks. WHEELCHAIRSAn individual must be measured properly, and the chair and seating system must fit those measurements:Adjust the chair for the individual. Make sure the individual knows how to operate all functions on the chairReplace worn parts as necessary. STANDERSIt's important to measure the individuals size, functional abilities and the standers purpose. Once delivered, it must be properly adjusted. Do regular routine maintenance checks with parts replacement as needed.RE-EVALUATION, TRAINING, FITTING & REPAIR. It is common for facilities to hold mobility clinics where the individual is evaluated for a device and a prescription is generated. Delivery of the device, re-evaluation, fitting and training will occur.INSURANCEKnowledge of insurance plans and the individual's financial situation is also important. Many plans will cover only one device in a several-year period of time. Understanding of these issues can help in choosing a device that is able to grow and change as needs change.Finding that balance between devices can be very liberating and increase an individuals ability to participate in work, recreation, or other pursuits. Life changes, and so do all of us. It is important to schedule annual visits with a health care professional to evaluate current devices and the potential for new or changes in a mobility prescription. Editors Note: This information was submitted by Beth Bullard, Director of Case Management/Patient Assessment Information Coordinator at Northern Colorado Rehabilitation Hospital in Johnstown. She can be reached at ncrh.ernesthealth.com

Most people are unaware that there is a branch of medicine specifically dedicated to the diagnosis and treatment of temporary and/or chronic physical disability. Physiatry (pronounced Fizz-Eye-A-Tree) is the area of medicine wherein physicians specializes in Physical Medicine& Rehabilitation. (PM&R). Physiatrists are trained to focus on the patient as a whole person and to put the medical management of a disabling event within the context of that individuals life and environment. The roots of the specialty can be traced back to the 1930s. Demand for, prominence of , and national interest in the role of these specialists rose during WWII and again during the Vietnam war when young veterans returned home with a range of injuries that necessitated rehabilitation. Today there are over 7000 Board Certified physiatrists in the U.S.Helping to Keep the Golden Years GoldenPhysiatrists, focus on the patient as a whole person, young or old. Most specialties deal primarily with illness and possible threats to life. The physiatrist deals with these as well as addressing threats to living life fully. Attention is directed to restoring quality function in activities of daily life. These Rehab Medicine specialists often collaborate with a team of health professionals and other physicians in developing and carrying out a care plan that extends beyond hospital or clinic walls out into the family and community. This team may include physical therapists, occupational therapists, speech pathologists, prosthetists, and social workers.By partnering with a physiatrist, a persons primary care physician, neurologist, orthopedic surgeon, or neurosurgeon can enhance the ultimate chance of an individual doing well after or with conditions such as stroke; rheumatoid arthritis; total hip or knee replacement; sports-related injuries; musculoskeletal sprains and pain; neurological diagnoses such as multiple sclerosis, spinal cord injury, traumatic brain injury and ALS; as well as debility that can develop after prolonged critical illness. Asking for a referral to a physiatrist can be a priceless form of self-advocacy, since, even today, there remain many physicians, care managers, and home health care providers who are not familiar with the expertise available in the field of PM&R.Editors Note: This article was written by Indira S. Lanig MD, a physiatrist and Associate Medical Director at Northern Colorado Rehabilitation Hospital, Johnstown CO. The NCRH team of professionals can be reached at 970-619-3454

Physical Medicine and Rehabilitation Improving the health and function of seniors with disabilities can facilitate levels of participation in all aspects of society and can enhance health-related quality of life on a very personal level. For individuals recovering from a serious illness or disabling event, after their initial rehabilitation, the gains made in restoring function can be lost after returning home unless a community-based health and wellness program can be tailored to the individuals unique circumstances. Traditional definitions of health often described health and disability on opposite ends of the health spectrum. Fortunately, newer definitions, supported by the Department of Health and Human Services, acknowledge that health is multidimensional. Health promotion after disability therefore involves optimizing ones potential in the dynamic interplay of the physical, social, emotional, spiritual, and intellectual elements of being.An important first step in the process of designing a plan of self-care after a disabling event, is for seniors, health care professionals, and community service providers to collaboratively identify the many barriers that seniors with disabilities encounter when seeking to enhance their wellness and physical activity levels. Armed with a shared understanding of an individuals functional limitations, health status , and resources can allow for partnerships and networks of support that create opportunity for customized, adapted health promotion strategies. Physicians specialized in Physical Medicine and Rehabilitation (PM&R) are uniquely trained to facilitate and collaborate with other disciplines to address health related quality of life issues for persons with temporary or permanent disabilities. Self-advocacy therefore often includes the consultative involvement of rehabilitation specialists the in ones core team of health care providers helping to optimize ones health after injury or illness.Editors Note: This article was submitted by Indira S. Lanig MD, Medical Director at Northern Colorado Rehabilitation Hospital, in Johnstown, CO. The NCRH team of wellness-oriented physicians and therapists can be reached at 970-619-3454.