Comprehensive Geriatric Assessment Essay Example for Free

Comprehensive Geriatric Assessment EssayThe gerontological legal opinion is a multidimensional, multidisciplinary diagnostic instrument designed to collect instruction on the medical, psycho accessible and functional capabilities and limitations of elderly patients. Various geriatric practitioners use the information generated to develop treatment and long-term follow-up plans, arrange for primary care and rehabilitative services, organize and facilitate the intricate process of case management, determine long-term care requestments and optimal placement, and make the best use of health care resources.The geriatric assessment differs from a standard medical evaluation in three general ways (1) it focuses on elderly individuals with complex problems, (2) it emphasizes functional status and tincture of life, and (3) it frequently takes advantage of an interdisciplinary group of providers. Whereas the standard medical evaluation works reasonably well in or so other populat ions, it tends to miss some(prenominal) of the most prevalent problems faced by the elder patient. These challenges, often referred to as the Five Is of Geriatrics, include intellectual impairment, immobility, instability, incontinence and iatrogenic disorders. The geriatric assessment in effect addresses these and many other areas of geriatric care that are crucial to the successful treatment and prevention of disease and disability in older people. Performing a comprehensive assessment is an ambitious undertaking. Below is a list of the areas geriatric providers may choose to assess Current symptoms and illnesses and their functional impact. Current medications, their indications and effects. Relevant ancient illnesses. Recent and impending life changes. Objective measure of overall personal and social functionality. Current and future living environment and its appropriateness to function and prognosis. Family shoes and availability. Current caregiver ne twainrk including its deficiencies and potential. Objective measure of cognitive status. Objective assessment of mobility and balance. Rehabilitative status and prognosis if ill or disabled. Current delirious health and substance abuse. Nutritional status and needs. Disease risk factors, screening status, and health promotion activities. Services required and received.The primary care physician or community health worker usually initiates an assessment when he or she detects a potential problem. Like any effective medical evaluation, the geriatric assessment needs to be sufficiently flexible in scope and adaptable in content to serve a wide range of patients. A tell apart geriatric assessment, performed by multiple personnel over many encounters, is best suited for elders with multiple medical problems and significant functional limitations.Ideally, under these circumstances, an interdisciplinary team representing medicine, psychiatry, social work, nutrition, physical and occupational therapy and othe rs performs a detailed assessment, analyzes the information, devises an intervention strategy, initiates treatment, and follows-up on the patients progress. Due to the intricate nature of comprehensive assessments, many teams designate a case-manager or caseworker to coordinate the entire effort.Most assessments take place in medical offices and inpatient units over multiple visits. If at all possible, however, at least(prenominal) one member of the team (rarely the physician) go out attempt to visit the patient at home. Despite the problem of low or no reimbursement, the typically high-yield of information from even a single home visit makes it an extremely efficient use of resources.Most geriatric assessments, performed under the constraints of time and money, tend to be slight comprehensive and more say. Although such modifications are best suited to relatively high-functioning elders living in the community, many practitioners find some version of a directed geriatric asses sment to be a more realistic tool in a busy practice. Patient-driven assessment instruments are also popular among geriatricians. inquire patients to consummate questionnaires and perform specific tasks notonly saves time, but also it provides useful insight into their motivation and cognitive ability. To the extent that patients are unable to complete the assessment themselves, practitioners resort to traditional patient interview techniques that frequently involve input from a family member or other caregiver.During your upcoming site visits, you will perform a directed geriatric assessment (DGA), ideally with the same patient, over two sessions. In the interest of education, most of your DGA instruments are student-driven, rather than patient-driven, and require relatively little information from caregivers who may or may not be available at the time of your visit. We have divided the DGA in two parts, each with three subsections. In Part I, you will perform an expanded medical interview covering the clinical recital, nutritional assessment and a social evaluation. In Part II, you will perform neuropsychiatric, physical and functional examinations.What follows is a reproduction of the History and natural (HP) format that you will use in your Physical Diagnosis II course next semester. Although all geriatric practitioners do not use a standard assessment format (comprehensive or otherwise), most agree on basic content. The comprehensive geriatric assessment (history examination) following the Physical Diagnosis outline covers the most significant content areas of a prototypic geriatric assessment. As you can see, it moves well beyond the standard HP, which is precisely the point. We have designed it to correlate as closely as possible with the history and physical you will be learning later this year. It is to your considerable advantage to review this information before meeting your patients face-to-face on the site visits. The DGA instrument you will use during your encounter immediately follows this section.