Comprehensive Assessment Flashcards
Define Functional Capacity
Person’s ability to perform tasks that are required for living
What are the two key divisions of functional capacity?
- Basic Activities of Daily Living (ADL’s)
2. Instrumental Activities of Daily Living (IADL)
What Katz Index of Independence in ADL score would indicate a highly independent elder?
Score of 6
What Katz Index of Independence in ADL score would indicate a very dependent elder?
Score of 0
List the 5 Instrumental Activities of Daily Living (IADL)
- Housework
- Preparing meals
- Taking medications properly
- Managing finances
- Using a telephone
What Scale would you use to assess IADL’s?
Lawton Instrumental Activities of Daily Living Scale (9 Q’s)
What are the 4 components of the comprehensive geriatric assessment?
- Functional Capacity
- Physical Health: Pharmacy
- Cognition/Mental health
- Socio-Environmental
What 5 topics does the physical health component cover?
- Nutrition
- Vision/Hearing
- Balance and Fall prevention
- Fecal and Urinary incontinence
- Polypharmacy
What vitamins/minerals are elderly deficient in?
- Vitamin A, C, D
- B12
- Calcium
- Zinc
- Iron
What does Nutritional Health Checklist of 0-2 mean? Recommendation?
Good nutrition
Re-check nutrition score in 6 months
What does Nutritional Health Checklist of 3-5 mean? Recommendation?
Moderate nutritional risk
Re-check nutrition score in 3 months
See what you can do to improve eating habits and lifestyle
What does Nutritional Health Checklist of 6+ mean? Recommendation?
High Nutritional Risk
Bring checklist to physician or dietician for help to improve nutritional status
What increased risks is low vision associated with?
- Falls
- Cognitive decline
- Depression
Who should have a vision assessment?
- Falls
- Cognitive Declines
- Functional impairment
What are common causes of vision impairment?
- Presbyopia
- Glaucoma
- Diabetic Retinopathy
- Cataracts
- Age-Related Macular Degeneration
What is the 3rd MC ailment in elderly?
Hearing
At what age do we screen for hearing loss?
65+
What tests do we use to test for hearing loss?
- Surveys
- Whispered voice test
- Audiometry
What is hearing loss associated with?
- Cognitive decline
- Functional impairment
- Depression
- Social Isolation
- Poor self-esteem
- Increased hospitalizations
What Hearing Handicap Inventory score is considered a No Handicap/No Referral
0-8= 13% probability of hearing impairment
What Hearing Handicap Inventory score is considered a mild-to-moderate handicap/referral?
10-24= 50% probability of hearing impairment
What Hearing Handicap Inventory score is considered a severe handicap/referral?
25-40= 84% probability of hearing impairment
When should you refer your patient to a otolaryngologist?
If they fail the screening test
What is the TOC in hearing loss?
Hearing Aids
What are the complications of urinary incontinence?
- UTI’s
- Sepsis
- Decubitus ulcers
- Renal Failure
- Increased mortality
What is the key deciding factor in urinary incontinence?
Nursing home placement
What is the leading cause of hospitalizations and injury-related death in 75+?
FALLS
What is a Normal Time for the Get up and Go test (Tinetti Balance & Gait Evaluation)
7-10 seconds
What is a Fairly Mobile time for the Get up and Go test
10-19 seconds
What is a Variable Mobile time for the Get up and Go test
20-29 seconds
What is a Functionally Dependent in Balance and. Mobility time for the Get up and Go test
30 seconds or more
How can older persons reduce their fall risk?
- Exercise
- Home Hazard Assessment
- Remove Psychotrophic meds
What is the USPSTF osteoporosis screening recommendation in women?
Screen women 65+ with DEXA of femoral neck
Osteoporosis T-score
-2.5 or lower
Osteopenia T-score
-1 to -2.5
What percentage of hospital admission in older people is secondary to drug ADE’s?
30%
How do older adults present with depression?
Atypical Presentation:
- Somatic complaints
- Cognitive/functional problems
- Sleep disturbances
- Fatigue
What screening can you use to easily identify pt’s @ risk for depression?
Two Q screening
- Bothered by feeling down, depressed, or hopeless?
- Little interest or pleasure in doing things
If the patients has a positive screen to both Q’s, what should you follow-up with?
7 additional Q’s to complete Patient Health Questionnaire (PHQ-9)
PHQ-9 Score for Minimal Depression
1-4
PHQ-9 Score for Mild Depression
5-9
PHQ-9 Score for Moderate Depression
10-14
PHQ-9 Score for Moderately Severe Depression
15-19
PHQ-9 Score for Severe Depression
20-27
What is a quick initial screening you can use to assess for dementia?
Mini-Cognitive Assessment Instrument: 3 Q’s
- Repeat 3 unrelated words
- Draw clock
- Repeat 3 words from step 1
*One point for each item that is recalled correctly
What is the most widely used assessment for dementia?
Mini Mental Status Exam: 7-10 Q’s
