The Geriatric Comprehensive Assessment

What is it? (According to lectures)

“multidimensional interdisciplinary diagnostic process focused on determining a frail older person’s medical, psychological and functional capability in order to develop a co-ordinated and integrated plan for treatment and long term follow up”
Basically a way of making a problems list and an associated solutions/interventions list.
It involves 4 main areas to concentrate on:
  1. Medical
    1. Presenting complaint(s)
      1. NB These are not always diagnoses but can be problems e.g. confusion/off legs/falls etc
    2. Co-morbid conditions and disease severity
    3. Medication review
    4. Nutritional status
  2. Psychological
    1. Mental status (MMSE)/cognitive function
    2. Mood/depression evaluation
  3. Functioning
    1. Basic and extended ADL’s
    2. Activity/exercise status
    3. Gait and balance
  4. Social
    1. Informal needs and assets
    2. Care resource eligibility
    3. Safety
    4. Social interaction

Why is it important?

  • Because older people rarely have one problem and simply treating a presenting complaint is of little benefit.

Example:

  • A 78-year-old woman, for example, is recovering from a stroke in an acute care hospital. She is left with persistent right upper and lower extremity weakness and mild dysarthria (difficulty speaking). Physical and occupational therapy have already evaluated her, and she wishes to return home.

 

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