Geriatric Assessment Flashcards
1
Q
What are some issues in geriatrics that complicate the assessment of the pt?
A
often present w/:
- complex medical, psychological and social problems that have previously been managed by multiple healthcare providers
- long list of meds
- cognitive issues
- hearing impairment
- fxnl disabilities not uncovered by the traditional h and p
2
Q
What is tested on the MMSE?
A
- orientation
- registration
- attention and calculation
- recall
- language
- clock drawing
3
Q
What is a part of the fxn; assessment?
A
- what is pt able to do physically, intellectually and socially
- measure fxnl status as it changes over time
- ADLs: skills needed to live at home
- IADLs: skills needed to live independently in community
4
Q
What are basic ADLs?
A
- personal hygiene
- dressing
- eating
- transferring from bed to chair and back
- toileting
- continence
- communication
- visual capability
- use of upper extremities
5
Q
What is the physical self maintenance scale?
A
- best indicated when functionality is major or likely an issue - dementia or chronically disabled
- often better results if done by social service agent w/ home visit
- assesses need for services
- assess level of care needed when placement is anticipated
6
Q
What are IADLs?
A
- more complex activites an individual needs for independent living
- learned skills and capability to carry them out
- has clear implications for future management
examples: - obtaining and preparing food
- manage transportation:
driving, bus schedule, taxi, shopping, cooking - laundry
- housekeeping
- using phone
- managing finances
- meds
7
Q
What is considered a geriatric vital sign?
A
- WEIGHT
- have to ask if pt eats less than 2 meals a day
- mini-nutritional assessment
8
Q
Questions to ask about continence and falls?
A
- in past yr: do you ever lose your urine and get wet? do you use depends or pads? - in last 12 months: Have you ever fallen and hurt yourself? Are you afraid that you will fall b/c of balance or walking problem? Have you fallen 2 or more times?
9
Q
Vision and hearing tests?
A
vision:
near and far vision
amsler grid
hearing:
ear exam
hearing aids?
audioscreen
10
Q
Why is there a caregiver assessment?
A
- vitally contributes to assessment
- quality, skills, and knowledge of caregiver are essential determinants of std of, potential for, future care
- good caregiver can be therapeutic tool
- failure of caregiver skill and capacity often precipitates hospital or institutional placement or abuse
- ensure caregiver is operating optimallyand that the more dependent phase of pt’s illness can be postponed for as long as possible
- ensure caregiver is not overloaded or burnt out - know when to offer caregiver respite
11
Q
Apsects of caregivers that make them esp. vulnerable to stress?
A
- their own frailty: spouse is caregiver 70yo caregiver to 90yo pt ETOH depression illness caregiver demands (sandwich generation) - stressful aspect of pt: disturbed nights uncontrolled aggression wandering falling uncontrolled incontinence inability to walk w/o assistance - some attempt to do everything to alleviate guilt or prior poor relationship w/ parent, others encourage independence, overzealous care can easily induce dependence
12
Q
What can we find on abdomen exam?
A
- bowel sounds
- fecal impaction
- over distended bladder
- finding may be subtle - even a soft, mildly tender abdomen can mean presence of serious surgical disease
13
Q
What is involved in Musculoskeletal exam?
A
- lower extremities: gait and mobility - get up and go test
- upper extremities: touch back of head w/ hands, pick up spoon
- ROM
14
Q
Neuro exam components?
A
- mental status
- cranial nerves
- DTRs
- senstation, vibratory senses
15
Q
What are geriatric assessment benefits?
A
- new dx
- fewer meds (taper 1 off at a time)
- improved fxnl status
- preserving independence
- increased use of home health services
