Comprehensive Geriatric Assessment Flashcards
What are the implications of an ageing world?
Multi-morbidity
Frailty
Describe ageing and redundancy
Progressive accumulation of damage to a complex system resulting in aggregate loss of system redundancy
What does age related decline lead to?
Impairment of individual organ function
Breakdown of the complex interplay between organ systems
Increased susceptibility to environment stress - frailty
What is frailty?
A reduced ability to withstand illness without loss of function
What is included in the frailty phenotype?
Unintentional weight loss
Exhaustion
Weak grip strength
Slow walking speed
Low physical activity
3/5 of criteria
What is included in frailty syndrome?
Falls, immobility, delirium and functional loss
What does ‘think FRAIL’ mean?
F - functional impairment
R - resident in a care home
A - acute confusion
I - immobility or falls
L - list of 6 more medicines
What is the scoring of the clinical frailty score?
1-9
1 being very fit
9 being terminally ill
Dementia patients are scored differently
What is the illness trajectory in frailty?
Steady level then decline - crisis - admission - reablement
New functional ability is lower than the start
What is a comprehensive geriatric assessment?
Process to assess and manage illness in older people with frailty
Determine what the problems are, what can be reversed and what can be made better
What does goal centred approach mean?
Mean we do what the patient wants
Person centred
Preserves autonomy
Effective way of dealing with multi-morbidity and competing clinical priorities
What is included in medical domain?
Is it pathological or physiological
Reversible and non-reversible
Iatrogenic harm
Infection
What is spiritual care focused on?
Person centred care
What is included in physiological domain?
Mood - low mood and anxiety
Confidence
Cognition - delirium and dementia
What is included in functional domain?
Mobility
Activities of daily living
Community living skills
