Geriatric Assessment

Question 1

What are the 4 key concepts that inform/guide approach to geriatric care?

Answer 1

Teams/clinical sites of care
Prognosis
Patient goals
Functional status

Question 2

When should you consider palliative care services

Answer 2

PTS w/ <18 months

Question 3

When should you consider hospice care?

Answer 3

When a patients has <6 mos to live

Question 4

What do you use for ADLs?

Answer 4

Katz index

Question 5

What do you use for IADLs?

Answer 5

Lawton scale

Question 6

When should you follow up on a patients functional status?

Answer 6

After initial visit then periodically

1. After hospitalization, illness, louse of spouse

Question 7

What can a functional assessment help determine?

Answer 7

Monitor for future declines
Need for support devices
Need for med/surgery
Need for rehab

Question 8

ADL decline typically indicates what?

Answer 8

WORSENING of a specific disease and/or combined impact of multiple comorbidities

Question 9

New or subtle declines in IADL function may indicate what?

Answer 9

1. Presence of disease
2. Loss of vision or hearing
3. Fear of falling
4. Depression/ dementia

Question 10

For highly functioning elders, how can you suspect depression or dementia?

Answer 10

Find an activity that they like and monitor, if they stop doing it then start to suspect depression/dementia

Question 11

What are the leading cause of non fatal/unintentional injuries and death in older persons?

Answer 11

Falls

Question 12

How often should you question about falls?

Answer 12

Annually

Question 13

Gait contributes to ___, gait and balance should be assessed ___ __. They are sensitive for detecting ___, muscle weakness, and ___ impairments.

Answer 13

Falls, every visit, arthritis, neurological

Question 14

What test measures patients strength, gait, balance, judgement and use of assistance devices?

Answer 14

Get up and go

Question 15

If a times get up and go test is slowed what does that indicate?

Answer 15

ADL impairment

Question 16

Snellen eye chart measures ___ and jaeger measures ___

Answer 16

Far, near

Question 17

What hearing test is easy to perform and has high sensitivity and specificity?

Answer 17

Whisper test

Question 18

What score indicates hearing loss on the clinical scale to detect hearing loss?

Answer 18

> =3

Question 19

What are two tests that are widely used to screen for dementia?

Answer 19

Mini-mental state exam: 10 min

Mini-Cog exam: quick, 3 item recall + clock drawing

Question 20

What are the two questions you can ask for depression?

Answer 20

Past 2 weeks depressed?

Past 2 weeks lack of interest/pleasure?

If either is yes, investigate

Question 21

Unintentional weight loss __ requires further evaluation?

Answer 21

> 5%

Question 22

Treatment for abuse?

Answer 22

Refer to social worker

Question 23

How much excersice?

Answer 23

30/ day

Question 24

What immunizations should you recommend?

Answer 24

Influenza annually
Pneumococcal 65
Tetanus/diphtheria q 10 years
Tetanus/diphtheria/pertussis once
Herpes zoster 60/older