GERIATRIC ASSESSMENT Jane Courtney. 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.
• Disease—an intrinsic pathology or disorder . . . [which] may or may not make [itself] evident clinically
• Impairment—a loss or abnormality of structure or function at the organ system level
• Disability—a restriction or lack of ability to perform an activity in a normal manner, a disturbance in the performance of daily tasks
• Handicap—a disadvantage resulting from impairment or disability that limits or prevents fulfillment of a role that is normal
(SYMPTOMS & SIGNS)
Poor hand function
Carcinoma of prostate
ACTS OF DAILY LIVING (ADL’s)
BARTHEL ADL index
FUNCTIONAL INDEPENDENCE MEASURE (FIM)
MINI MENTAL STATE EXAM MMSE (FOLSTEIN’s)
GERIATRIC DEPRESSION SCALE (GDS)
D.Dressing upper body
E.Dressing lower body
I.Bed, chair, wheelchair
Score: 1 – 7 for each of 18 items (126)
Independence:7—complete independence (timely, safely)
6—modified independence (device used)
4—minimal assistance (>75% of task)
3—moderate assistance (50%-74% of task)
2—maximal assistance (25%-49% of task)
Complete dependence:1—total assistance (subject performs <25% of task)
1 ORIENTATION- TIME(5)
2 ORIENTATION – PLACE(5)
7 “NO IF ANDS OR BUTS”(1)
8 “3 STAGE COMMAND”(3)
9 “CLOSE YOUR EYES”(1)
10 WRITE A SENTENCE(1)
GERIATRIC DEPRESSION SCALE
WHAT DO WE DO WITH THIS ASSESSMENT?
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”.)
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
AGED CARE ASSESSMENT TEAM (ACAT)
ASSESS FOR APPROVAL OF GOVERNMENT FUNDING FOR CARE
CO-LOCATED IN GERIATRIC DEPARTMENTS.