Elderly- Comprehensive Geriatric Assessment Flashcards
What is the function of a comprehensive geriatric assessment?
A process to assess and manage disruption to health in older people with frailty
What is ageing?
Progressive accumulation of damage to a complex system resulting in aggregate loss of system redundancy
What does a loss of system redundancy lead to?
Decreased resilience to overcome environmental stress
Resulting in an increased risk of system failure
What is frailty?
State of susceptibility
How can you identify someone as fail?
Frailty index
Frailty phenomenon
They tend to present with decompensated frailty syndrome
What is decompensated frailty syndrome?
System failure presentations • Falls • Incontinence • Delirium • Functional decline
What is a Comprehensive Geriatric Assessment?
A multidimensional interdisciplinary diagnostic process focused on determining a frail elderly person’s medical, psychological and functional capability in order to develop a co-ordinated and integrated plan for treatment and long term follow up
What does a comprehensive geriatric assessment include?
- Goal centred
- Holistic
- Multidisciplinary
What is goal centred vs problem centred?
The goal and focus is the life, not the disease
It is about what the person wants, not what the doctor wants
What is a holistic approach?
Broad approach to health
Health is a dynamic process rather than a binary state
What are the health domains?
Medical, psychological, nutritional, spiritual, environmental, social etc.
Illness in frail people leads to disruption in multiple health domains
What happens to the health domains in an ill, frail person?
There is disruption in multiple health domains
How is the psychological heath domain disrupted?
- Mood- Low mood, Anxiety
- Confidence- Fear of falling
- Cognition- Delirium, Dementia
How is the nutritional health domain disrupted?
- Poor nutrition leads to ill health
- Ill health leads to poor nutrition
- MUST screening tool
What does environmental health domain encompass?
- Housing
- Heating
- Sanitation
- Adaptation
What does the social health domain encompass?
- Support networks- Practical/emotional, Formal/informal
* Potential for abuse- Financial, Physical, Sexual, Neglect
Who is involved in the multidisciplinary team that carries out the multidisciplinary assessment?
- Doctors
- Physiotherapists
- Occupational therapist
- Nurses
What do the doctors look at?
The medical contributors to disruption to health
What do the physiotherapists assess?
Mobility
What do the occupational therapists assess?
Function
What does the nurse do?
Provide care and assessment over long period of time
When is the optimal discharge of patients?
When the benefits outweigh the risks or when the goals are met
What are the benefits to a patient being in hospital?
- Access to clinical expertise
- Access to complex tests and interventions
- Rapid access to supervised care support
What are the risks of a patient being in hospital?
- Disorientation and delirium
- Learned dependency
- Deconditioning
- Iatrogenic harm
- Hospital Acquired Infection
