Comprehensive Geriatric Assessment

Question 1

What is frailty?

Answer 1

a reduced ability to withstand illness without loss of function

(it is susceptibility to functional decline)

Question 2

What implications are there to ageing?

Answer 2

Multimorbidity
Progressive accumulation of damage resulting in organ impairment
Dyshomeostasis

Question 3

What is the criteria to identify frailty?

Answer 3

Unintentional weight loss
Exhaustion
Weak grip strength
Slow walking speed
Low physical activity

Question 4

What features/symptoms accompany frailty?

Answer 4

Falls
Immobility
Delirium
Functional loss

Question 5

What is the clinical scale of frailty?

Answer 5

1 - very fit
2 - well
3- managing well
4- vulnerable
5- mildly frail
6- moderately frail
7- severely frail
8- very severely frail
9- terminally ill

Question 6

What are the multiple health domains that can be affected by frailty?

Answer 6

Medical, psychological, functional, behavioural, nutritional, spiritual, environmental, social, societal

Question 7

What is comprehensive geriatric assessment?

Answer 7

process to assess and manage illness in older people with frailty

• determine what the problems are
• determine if anything is reversible
• produce management plan

Question 8

What is spiritual care?

Answer 8

Person centred care (not necessarily religious etc)

Question 9

What features make up the psychological domain?

Answer 9

Mood - anxiety, low mood
Confidence
Cognition - delirium, dementia

Question 10

What features make up the functional domain?

Answer 10

Mobility

Activities of daily living

Question 11

What features make up the behavioural domain?

Answer 11

Activities/ pastimes
Occupation
Unhealthy eating/ smoking/ drinking

Question 12

What are features of the nutritional domain?

Answer 12

poor nutrition leads to ill health
ill health leads to poor nutrition
MUST screening tool

Question 13

What features make up the environmental domain?

Answer 13

Housing
Heating
Sanitation
Adaptation

Question 14

What features make up the societal domain?

Answer 14

attitudes to ageing/ aged
technological advance
political/ regulations: money, accessibility

Question 15

What are the benefits of a comprehensive geriatric assessment?

Answer 15

More likely to be alive and living at home
Less likely to be living in residential care
Better outcomes with CGA

Question 16

What are the risks of frail patients staying in hospital?

Answer 16

Disorientation and delirium
Learned dependency
Deconditioning
Iatrogenic harm
HAI