GERIATRIC ASSESSMENT

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GERIATRIC ASSESSMENT Jane Courtney
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family
Community support
nurses
Speech therapist
pharmacist
dietician
Multi-disciplinary team
Multi-disciplinary team
geriatrician
physiotherapist
Local doctor
Occupational therapist
psychologist
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World Health Organization definitions of
disability.  Diseasean intrinsic pathology or
disorder . . . which may or may not make
itself evident clinically  Impairmenta loss
or abnormality of structure or function at the
organ system level  Disabilitya restriction or
lack of ability to perform an activity in a
normal manner, a disturbance in the performance
of daily tasks  Handicapa disadvantage
resulting from impairment or disability that
limits or prevents fulfillment of a role that is
normal
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PATHOLOGY (DISEASE)
IMPAIRMENT (SYMPTOMS SIGNS)
DISABILITY (FUNCTIONAL LOSS)
HANDICAP (SOCIAL CONSEQUENCES)
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DIAGNOSES
DISABILITIES
Rheumatoid arthritis
Poor mobility Pain Poor hand function
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Carcinoma of prostate TURP Radiotherapy
Hormonal therapy Skeletal metastases
Incontinence Hot flushes Faecal urgency Pain
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ACTS OF DAILY LIVING (ADLs)
MOBILITY- independent with aid ( ) assist wheelchair bedbound TRANSFERS- independent assist not
TOILET USE- independent assist not GROOMING- independent assist not
SHOWERING- independent assist not DRESSING- independent assist not
FEEDING- independent assist not CONTINENCE- bladder bowels
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COGNITION - MEMORY PROBLEM SOLVING SOCIALISA
TION BEHAVIOUR DOMESTIC FUNCTIONS- SHOPPING
COOKING CLEANING TRANSPORT
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BARTHEL ADL index FUNCTIONAL INDEPENDENCE
MEASURE (FIM) MINI MENTAL STATE EXAM MMSE
(FOLSTEINs) GERIATRIC DEPRESSION SCALE (GDS)
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FIM (motor)
 Self-care    A.Self-care  B.Grooming 
C.Bathing  D.Dressing upper body  E.Dressing
lower body  F.Toileting 
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Sphincter control    G.Bladder management 
H.Bowel management
 Mobility (transfer)  I.Bed, chair, wheelchair 
J.Toilet  K.Tub, shower
Locomotion    L.Walk/wheelchair  M.Stairs
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FIM(cognitive)   Communication 
  N.Comprehension  O.Expression
Social cognition  P.Social integration 
Q.Problem solving  R.Memory
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Score 1 7 for each of 18 items (126)
Independence 7complete independence (timely,
safely)  6modified independence (device
used)  Modified dependence 5supervision 
4minimal assistance (gt75 of task) 
3moderate assistance (50-74 of
task)  2maximal assistance (25-49 of
task)  Complete dependence 1total assistance
(subject performs lt25 of task)
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MMSE 1 ORIENTATION- TIME (5) 2 ORIENTATION
PLACE (5) 3 REGISTRATION (3) 4
CALCULATION (5) 5 RECALL (3) 6
NAMING (2) 7 NO IF ANDS OR BUTS (1) 8 3
STAGE COMMAND (3) 9 CLOSE YOUR EYES (1) 10
WRITE A SENTENCE (1) 11 PENTAGONS (1)
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GERIATRIC DEPRESSION SCALE
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WHAT DO WE DO WITH THIS ASSESSMENT?
PLAN CARE
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Rehabilitation is a problem solving and
educational process aimed at reducing the
disability and handicap experienced by someone as
a result of a disease, always within the
limitations of available resources. (ICIDH
quoted in oxford textbook of geriatrics.)
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1 assess- identify, analyze measure problems 2
plan- analyze problem(s) set goals 3 treat-
intervene to reduce disability handicap 4
care- intervene to alleviate consequences of
disability 5 evaluate- check effectiveness
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AGED CARE ASSESSMENT TEAM (ACAT)
ASSESS FOR APPROVAL OF GOVERNMENT FUNDING FOR CARE
CO-LOCATED IN GERIATRIC DEPARTMENTS.