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Akbari A, Motiee M, Rahmani F, Moradi B. Rehabilitation Care Challenges for Older Adults: A Narrative Review. , IJN. 2025; 38 (S1 )
URL: http://ijn.iums.ac.ir/article-1-3947-en.html
URL: http://ijn.iums.ac.ir/article-1-3947-en.html
1- Nursing Department, Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ,mahdiehmotie711@gmail.com
3- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ,
3- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract: (722 Views)
Background & Aims The global rise in the aged population has increased the need for effective rehabilitation care to maintain functional independence in older adults. Despite their proven benefits, rehabilitation services for older adults face numerous barriers, particularly in middle-income countries such as Iran. This study aimed to investigate rehabilitation care challenges for older adults at both national and international levels.
Materials & Methods This is a narrative review. A systematic search was conducted in MagIran, Scientific Information Database (SID), IranDoc, PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2008 and 2024. Original quantitative or qualitative studies addressing barriers to geriatric rehabilitation care were included. Data analysis was conducted using Graneheim and Lundman’s qualitative content analysis method. The data were synthesized and categorized into main themes.
Results Of 98 retrieved records, 23 studies met the inclusion criteria (15 Iranian, 8 international). Challenges were classified into seven main domains: structural (architectural barriers, lack of appropriate facilities, lack of equipment), behavioral (communication problems, older adults’ misbehavior, poor diet/medication adherence, shortage of staff/service providers, lack of rehabilitation knowledge, lack of palliative and end-of-life care knowledge), educational (insufficient staff training, inadequate/inappropriate patient education, and lack of awareness about assistive technologies), socio-economic (inadequate insurance coverage/financial support, lack of voluntary services, and limited social and emotional support), functional (ineffective service systems, poor implementation of primary healthcare services, comorbidity, and caregiver shortages), governance/leadership (weak policy-making/lack of coordinated programs, and inactivity/low activity of the Elderly Health Council), and self-care (physical disabilities, cognitive decline, reduced resilience, visual impairments, dependency on caregivers, and psychological distress/uncertainty about the future/anticipation of death). Financial and rehabilitation process-related challenges were the most frequently reported barriers.
Conclusion Rehabilitation care for older adults faces multiple challenges in terms of structural, educational, behavioral, financial, functional, and governance domains. Strengthening community-based integrated rehabilitation models, expanding insurance coverage, enhancing nurses’ and family caregivers’ knowledge, and addressing governance fragmentation are priority strategies. Future research should focus on understudied areas such as governance challenges and behavioral barriers.
Materials & Methods This is a narrative review. A systematic search was conducted in MagIran, Scientific Information Database (SID), IranDoc, PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2008 and 2024. Original quantitative or qualitative studies addressing barriers to geriatric rehabilitation care were included. Data analysis was conducted using Graneheim and Lundman’s qualitative content analysis method. The data were synthesized and categorized into main themes.
Results Of 98 retrieved records, 23 studies met the inclusion criteria (15 Iranian, 8 international). Challenges were classified into seven main domains: structural (architectural barriers, lack of appropriate facilities, lack of equipment), behavioral (communication problems, older adults’ misbehavior, poor diet/medication adherence, shortage of staff/service providers, lack of rehabilitation knowledge, lack of palliative and end-of-life care knowledge), educational (insufficient staff training, inadequate/inappropriate patient education, and lack of awareness about assistive technologies), socio-economic (inadequate insurance coverage/financial support, lack of voluntary services, and limited social and emotional support), functional (ineffective service systems, poor implementation of primary healthcare services, comorbidity, and caregiver shortages), governance/leadership (weak policy-making/lack of coordinated programs, and inactivity/low activity of the Elderly Health Council), and self-care (physical disabilities, cognitive decline, reduced resilience, visual impairments, dependency on caregivers, and psychological distress/uncertainty about the future/anticipation of death). Financial and rehabilitation process-related challenges were the most frequently reported barriers.
Conclusion Rehabilitation care for older adults faces multiple challenges in terms of structural, educational, behavioral, financial, functional, and governance domains. Strengthening community-based integrated rehabilitation models, expanding insurance coverage, enhancing nurses’ and family caregivers’ knowledge, and addressing governance fragmentation are priority strategies. Future research should focus on understudied areas such as governance challenges and behavioral barriers.
Keywords: Rehabilitation, Aged, Health services for the aged, Health services accessibility, Rehabilitation nursing
Type of Study: Review |
Subject:
nursing
Received: 2025/09/14 | Accepted: 2025/12/22 | Published: 2025/03/21
Received: 2025/09/14 | Accepted: 2025/12/22 | Published: 2025/03/21
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