Flashcards in Geriatric Assessment Deck (50)
Define Geriatric Assessment
Multidimensional diagnostic approach to the screening & diagnosis of the physical, psychological & social impairments and the attendant functional disabilities in the frail elderly with the objective of developing an overall treatment plan which will improve the patient's QOL
Goals of a Geriatric Assessment
Define functional capabilities & disabilities
Evaluate the mental & emotional strengths & weaknesses
Appropriately manage acute & chronic diseases
Promote prevention & health
Establish preference for care in various situations
Understand financial resources available for care
Understand social networks & family support systems of care
Items Elderly Patients Present with
Complex medical, psychological & social problems that are managed by multiple providers
Long medication lists
Functional disabilities not found in a traditional H&P
Office Environment for the Elderly
Limit background noise
Face the patient & speak in a low-pitched voice
Providing pen & paper
Encourage nodding or shaking of the head
Patient Encounter with an Elderly Person
Address patient with title & last name
Make patient the focus of attention
Direct all questions to the patient
Family may be present
Family Members in on an Elderly Patient's Visit
Understand that the patient should answer all questions
Can provide details about patient's illness & social situation
Assist with the treatment plan
Work as a team in achieving goals of care
Crucial to the care of patients with advanced dementia
Problem List in the Geriatric Population
Things to Consider with the Problem List of a Geriatric Patient
Formal diagnosis with functional severity
Syndromic problems that require a specific therapeutic plan
Contributory life events
Hx of continuing significance
Nursing home or assisted living
Hx of Continuing significance
Lifestyle Items of Importance
Do you drive?
Areas of Assessment & Screening in the Geriatric Population
Function (ADLs & IADLs)
Social & economic issues
Assessing Mental Status Changes
Mini mental status exam
Mini Mental Status Exam
Tests several areas of cognitive function
Measure of change over time
Encourage patient to make his/her best guess in response to the more factual questions
Parts of the Mini Mental Status Exam
Attention & Calculation
Define Functional Assessment
Patient is doing as much as possible physically, intellectually, socially, and being as independent as possible is a major objective of geriatric care
Reason for Monitoring Functional Assessment
Helps to appreciate deterioration & improvement over time
What is vital to properly make any medical decisions?
Knowledge of the premorbid functionality & living situation
Define Activities of Daily Living
Skills needed to live at home
Define Instrumental Activities of Daily Living
Skills needed to live independently in the community
Dressing & undressing
Transferring from bed to chair & back
Use of the upper extremities
What is the physical self-maintenance scale used for?
Assesses need for services
Assess level of care needed when placement is anticipated
Most indicated when functionality is a major or likely issue
Instrumental Activities of Daily Living
Obtaining & preparing food
Using the telephone
What is the functional activities questionnaire used for?
Determine ability to do each IADL
Able to grade each function
Tailor to individual needs with each function
How to check for depression in the elderly?
Geriatric depression scale
How to check for mobility in the elderly?
Get up and go test
Nutrition in the Elderly Population
Eating at least 2 meals a day
Checking for Continence in the Elderly Individual
Ever lose your urine & get wet?
Use depends or pads?
Checking for Fall Risk in Elderly Individuals
Fall & hurt yourself?
Afraid you will fall because of balance or walking problem?
Fallen 2+ times?