Geriatric assessment
Geriatric assessment is a comprehensive evaluation process focused on understanding the multifaceted needs of older adults. This assessment explores various aspects of an individual's life, including medical, psychological, and social issues, as well as functional capabilities. It is adaptable to different clinical settings, ranging from home care to hospitals, and is utilized by a diverse array of healthcare professionals. By gathering detailed information, healthcare providers can collaboratively develop tailored treatment plans that include short-term and long-term goals.
The process emphasizes the importance of involving older adults in decision-making, while also valuing the contributions of family members and caregivers, particularly when cognitive impairments are present. A thorough geriatric assessment may involve multiple encounters to ensure that all relevant areas are addressed, including medical history, cognitive status, mobility, emotional health, and social support. Unlike traditional medical evaluations, geriatric assessments prioritize quality of life and recognize the complex interconnections among various health issues. This holistic approach places the older adult at the center of care, promoting a coordinated effort among healthcare providers to enhance their well-being.
Geriatric assessment
Procedure
Anatomy or system affected: All
Definition: A tool used to gather information about an older adult.
Key term:
assessment: the process of documenting knowledge, evidence, skills, attitudes, beliefs, or other pertinent information so as to elucidate a phenomenon or contribute to understanding
Description and Background Information
Geriatric assessment investigates many different aspects of an older person's life: medical issues, psychological issues, social issues, functional capabilities, and limitations; activities such as driving, cooking meals, practicing adequate hygiene, and paying bills. It is an instrument that can be incorporated in a variety of clinical practice settings, from home care to hospital care, and everywhere in between.
Health care providers from all disciplines—including but not limited to doctors, nurse practitioners, social workers, case managers, and nurses—can use the information gathered from a geriatric assessment to create a treatment plan, establishing short-term goals, long-term goals, and a plan for follow-up, and generally make the best use of the health care resources available to the older adult. These efforts are ideally discussed and agreed upon by the health care provider(s) and older adult; however, family and caregiver input are valuable and often essential in the case of the older adult with cognitive impairment or other debilitating disease.
A truly comprehensive geriatric assessment may involve several encounters with an older adult (or caregivers, loved ones) initially over a period of time determined by the health care provider(s) and individual/family, and again at mutually agreed-upon intervals. The comprehensive assessment encompasses a wide variety of domains. Areas that may be investigated by geriatric specialists include:
- • A full, head-to-toe physical examination
- • Current symptoms, illnesses, or other stressors that may be impacting the older adult's life
- • Medications taken: what they are for, when they are taken, how are they being tolerated, are they affordable
- • Past and current illnesses: diagnoses, hospitalizations (if any), surgeries (if any)
- • Other major life events: marriage(s), deaths, personal successes, failures
- • Social health: involvement with neighborhood, community, region; includes presence of family, availability of family, and who the older person defines as family. Who is looking after this person, if anyone?
- • An objective measure of cognitive status
- • An objective assessment of mobility and balance
- • An assessment of the older adult's environment: neighborhood safety, home safety, adequate resources to maintain living situation
- • Emotional health; history of or current substance abuse
- • Nutritional status and needs; ability to prepare meals, food preferences and eating routines, any difficulties with chewing, swallowing, or obtaining food
- • Risk factors for disease, immunizations; health promotion activities
Geriatric assessment differs from a traditional medical evaluation in three important ways: (1) It focuses on elderly individuals, who often have complex, interconnected issues; (2) It emphasizes quality of life, and (3) It may be administered effectively through the collaboration of many different health care providers or just one health care provider. If several health care providers are involved in administering this assessment, one person (regardless of discipline) is often the coordinator. The coordinator facilitates group meetings or communiqués so that the multidisciplinary group can operate effectively and efficiently. The older adult is always the center of the mutually agreed-upon goals of care.
Bibliography
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