Comprehensive geriatric assessment

Question 1

What is a comprehensive geriatric assessment?

Answer 1

It is the gold standard for managing frail older people

Determines their problems so a management plan can be created

Question 2

What are the domains of the comprehensive geriatric assessment?

Answer 2

FRAIL
Falls/functional decline
Reactions (polypharmacy)
Altered mental status
Illness
Living situation

Question 3

What are some of the factors that contribute to falls and how can they be divided?

Answer 3

Split into personal, drug history and environment
Personal:
-Age
-sensory or visual impairment
-MSK - immobility, osteoporosis
-Neuro - parkinsons, dementia, 
-Cardio - hypotension
-Incontinence
Environment:
-Poor lighting
-Slippery floor
-Unstable furniture
-Stairs
-Who performs daily tasks
-Alcohol
Drugs:
-Antihypertensives
-Hypoglycaemics
-Sedatives
-Osteoporosis meds

Question 4

What must be considered when trying to rehab an older person?

Answer 4

Cognition
Pre morbid function
Accomodation
Social and family support

Question 5

When does capacity need to be assessed in older people?

Answer 5

It is individual to each decision so should be considered for each decision

Question 6

What are the requirements for capacity?

Answer 6

Need to understand the information
Retain the information
Consider the information
Communicate a decision

Question 7

What are the 2 types of lasting power of attorney?

Answer 7

Finance
Health
Same person can hold both roles

Question 8

What is a DOLS? When is this used?

Answer 8

This is a deprivation of liberty safeguards
This is when a person is in hospital and lacks capacity it can ensure that the person has appropriate representation and is regularly reassessed. Commonly used to stop people pulling out NG tubes