Office Based Geriatric Assessment

From Anvita Health Wiki

Contents 1 Indications 2 Procedure 3 Notes 4 More General Terms 5 References

Indications

• functional decline with changes in physical, mental, & social status

Procedure

• Assessment components:

• medical
• cognitive
• affective
• functional
• social support: caregiver
• economic
• environmental
• advance directives
• prevention
  

• Prescreening questionnaire:

• review of systems

• sensory impairment
• dentition
• mood
• memory
• urinary symptoms

• urinary incontinence
• urinary hesitancy
• dysuria
• urinary frequency

• falls
• sexual dysfunction
• nutrition
• pain

• activities of daily living (ADL)

• basic ADL
• instrumental ADL

• prevention

• vaccination: Pneumovax, influenza vaccine
• mammogram
• fecal occult blood
• exercise
• cholesterol
• supplements, vitamins, minerals
• seat belts

• advance directives
  

• Medical records
  
• Directed medical history

• review questionnaire & medical records
• hospitalizations & emergency room visits
• surgeries
• review medications & compliance each visit, prescription & OTC, including herbal supplements
  

• Directed physical examination

• guided by history/observation
• try to evaluate

• visual impairment
• hearing loss
• gait & balance

• Tinetti gait & balance
• get up & go test

• dentition
• mood ( geriatric depression scale)
• cognition/ memory

• minimental status
• clock test
• time & change test

• nutrition
• skin

• general: alertness, behavior, appearance
• cardiac: heart & carotid auscultation
• neurologic:

• focal neurologic signs
• signs of Parkinsonism

• rigidity, resting tremor, cogwheeling, bradykinesia

• orthostasis
  

• Plan of action:

• establish agreement on plan of action

• review findings
• prioritize next steps
• legible instructions
• follow-up visit
• referrals as needed

• touch patient in closing

Notes

• attenuates functional decline at no additional cost
• no survival benefit demonstrated [4]

More General Terms

• geriatrics

References

1. Moore, AA. In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
2. Koretz BK & Moore AA, Assessment of the Geriatric Patient, JCOM 8(7): 35, 2001 ([1]
3. Sloane PD Key Issues in the Primary Care of Alzheimer's disease In: Facilitating Diagnosis and Management of Alzheimer's Disease in the Primary Care Setting Internal Medicine World Report 20(11) suppl Nov, 2005
4. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
5. National Guideline Clearinghouse Neurologic assessment of the older adult. A guide for nurses. American Association of Neuroscience Nurses ngc-guideline: [2]

office-based geriatric assessment