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July 27, 1994

Outcomes of Older Patients Receiving Chronic Dialysis

Author Affiliations

Michigan State University East Lansing
Moss Rehabilitation Hospital Philadelphia, Pa

JAMA. 1994;272(4):274. doi:10.1001/jama.1994.03520040034029

To the Editor.  —We read with interest the article by Dr Ifudu and colleagues1 entitled "Dismal Rehabilitation in Geriatric Inner-City Hemodialysis Patients." They indicated that they "assessed functional rehabilitation of inner-city geriatric hemodialysis patients." We find the use of the word "rehabilitation" in this statement and title to be misleading. There seems to be confusion as to what constitutes rehabilitation. Webster's defines "rehabilitation" as the noun of the verb, rehabilitate—"to bring or restore to a normal or optimum state of health, constructive activity, etc, by medical treatment and physical or psychological therapy."2 This implies an active program of intervention, which in this case was only acute medical treatment (dialysis). Often, acute medical treatment is sufficient to restore an "optimum state of health" or "constructive activity," but on other occasions there needs to be active rehabilitation intervention in addition to this active medical treatment. Physiatrists would agree that restoration

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