Geriatric Assessment Flashcards
What are the 4 key concepts that inform/guide approach to geriatric care?
Teams/clinical sites of care
Prognosis
Patient goals
Functional status
When should you consider palliative care services
PTS w/ <18 months
When should you consider hospice care?
When a patients has <6 mos to live
What do you use for ADLs?
Katz index
What do you use for IADLs?
Lawton scale
When should you follow up on a patients functional status?
After initial visit then periodically
- After hospitalization, illness, louse of spouse
What can a functional assessment help determine?
Monitor for future declines
Need for support devices
Need for med/surgery
Need for rehab
ADL decline typically indicates what?
WORSENING of a specific disease and/or combined impact of multiple comorbidities
New or subtle declines in IADL function may indicate what?
- Presence of disease
- Loss of vision or hearing
- Fear of falling
- Depression/ dementia
For highly functioning elders, how can you suspect depression or dementia?
Find an activity that they like and monitor, if they stop doing it then start to suspect depression/dementia
What are the leading cause of non fatal/unintentional injuries and death in older persons?
Falls
How often should you question about falls?
Annually
Gait contributes to ___, gait and balance should be assessed ___ __. They are sensitive for detecting ___, muscle weakness, and ___ impairments.
Falls, every visit, arthritis, neurological
What test measures patients strength, gait, balance, judgement and use of assistance devices?
Get up and go
If a times get up and go test is slowed what does that indicate?
ADL impairment
Snellen eye chart measures ___ and jaeger measures ___
Far, near
What hearing test is easy to perform and has high sensitivity and specificity?
Whisper test
What score indicates hearing loss on the clinical scale to detect hearing loss?
> =3
What are two tests that are widely used to screen for dementia?
Mini-mental state exam: 10 min
Mini-Cog exam: quick, 3 item recall + clock drawing
What are the two questions you can ask for depression?
Past 2 weeks depressed?
Past 2 weeks lack of interest/pleasure?
If either is yes, investigate
Unintentional weight loss __ requires further evaluation?
> 5%
Treatment for abuse?
Refer to social worker
How much excersice?
30/ day
What immunizations should you recommend?
Influenza annually Pneumococcal 65 Tetanus/diphtheria q 10 years Tetanus/diphtheria/pertussis once Herpes zoster 60/older
