Assessment

Question 1

what is a comprehensive geriatric assessment?

Answer 1

a patient centred assessment

• problem list formed
• co-morbidities
• medication review
• nutritional status
• gait, balance and ADLs
• mood/ depression test
• cognitive function
• social support

Question 2

benefits of CGA

Answer 2

reduces mortality at 6 months 
improves function 
improves cognition 
reduces need for nursing home care 
reduces subsequent hospital admission

Question 3

frailty syndromes

Answer 3

off legs - poor mobility
falls 
confusion 
continence issues 
polypharmacy

Question 4

presentation of sepsis

Answer 4

BP may drop early (esp in those on vasodilating antihypertensives)
Tachycardiac response may be absent
temp often low, not high
CRP and WCC may not rise (or not much)
fluid balance may be hard
antibiotics should be targeted as higher risk C. diff

Question 5

keys in medication prescription

Answer 5

• Because older people have little homeostatic reserve, they are often delicately balanced
• Healthcare interventions therefore cause harm in many cases
• Timely treatment is important, but needs to be proportionate.
• Accurate diagnosis is the key to avoiding overtreatment, but still treating promptly