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Geriatrics > Comphrensive Geriatric Assessment > Flashcards

Comphrensive Geriatric Assessment Flashcards

1
Q

That does age related decline lead to?

A

Impairment of individual organ function
Breakdown of complex systems between organs (dyshomeostasis)

Leading to increased susceptibility to environmental stresses (frailty)

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2
Q

What is frailty?

A

Increased risk of death of debility following exposure to an environmental stressor

Or

A reduced ability to withstand illness without loss of function

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3
Q

What is involved in the illness trajectory of frailty?

A

A triggering event causes decline
Leading to a crisis, so there is an admission
Followed by a bit of reablement but patient will not return to pre-crisis functional ability

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4
Q

What kind of a problem is functional decline in frailty?

A

Aggressive, self perpetuating problem

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5
Q

What are the typical geriatric syndromes of presentation?

A

Falls
Immobility
Functional decline
Delirium

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6
Q

What is the WHO definition of health?

A

A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity

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7
Q

Why is the WHO definition of health BS?

A

Health is a dynamic rather than a binary state

Want to just make people feel better

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8
Q

What are the health domains?

A 
Medical
Psychological
Functional
Behavioural
Nutritional
Spiritual
Environmental
Societal
Social
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9
Q

What does illness in frail people tend to lead to?

A

Disruption in multiple health domains

Can also be triggered by any disruption in any health domain

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10
Q

What is our approach to treating elderly patients?

A

Try to make them feel better
Don’t just focus on the medical domain
Involve other health professionals/manage/coordinate care

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11
Q

What is the purpose of the CGA?

A

Assess and manage illness in older people

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12
Q

What does the CGA involve?

A

Determine what the problems are and what health domains are affected
Determine what can be improved/reversed
Make a management plan

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13
Q

Why are the health domains complicated?

A

They are all interlinked and affected by one another

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14
Q

What is involved in the medical health domain?

A

Pathological vs physiological
Determining if reversible or not
Avoiding iatrogenic harm and infections

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15
Q

What is involved in the psychological domain?

A

Mood (low mood, anxiety)
Confidence, eg fear of falling
Cognition (delirium, dementia)

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16
Q

What is involved in the functional health domain?

A

Mobility (transfers, mobilising)
Activities of daily living
Community living skills

17
Q

What is involved in the behaviour health domain?

A

Unhealthy eating, smoking, drinking
Activities/past times
Occupation

18
Q

What is involved in the nutritional health domain?

A

Poor health leads to poor nutrition, and vice versa

MUST is a screening tool

19
Q

What is the MUST screening tool used for and what does it involve?

A

????

20
Q

What is involved in the spiritual health domain?

A

How do you fit into the bigger picture?
What is important to you?
What’s the meaning of your life?
How do you like to project your self image?

21
Q

What is involved in the environmental health domain?

A

Housing
Heating
Sanitation
Adaptations

22
Q

What is involved in the social health domain?

A 
Support network (practical/emotional, formal/informal)
Potential for abuse (financial, physical, sexual, neglect)
23
Q

What are some societal issues with ageing?

A 
Attitudes to the aged (burden vs asset, paternalism)
Technological advance (enabling vs disabling) 
Political regulations (money, eg pensions/winter heating allowance or accessibility, eg free bus passes/disability badges)
24
Q

What are the key professionals involved in geriatric care?

A

Geriatric
OT
PT
skilled nurses

25
Q

What other professionals are involved in geriatric care?

A 
GP
Other doctors
Social workers
Home care
Dietician
SALT input
26
Q

What is involved in good geriatric care?

A

Early identification if need
Early CGA
Early provision of appropriate level of care for need

27
Q

What is the evidence for the benefit of the CGA?

A

Means patients are more likely to be alive or living at home in 6m/12m
And less likely to be living in residential care

With risk prediction we can prevent crisis and decline

28
Q

What improves elderly patients outcomes?

A

The earlier in the illness trajectory a frail person undergoes the process of CGA, the better the outcome is likely to be

Geriatrics (13 decks)

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