Critical Components of a ComprehensiveGeriatric Assessment Prepared by: TayseerMakharzih Saryabohaniah Noor Khawlah Naysem
Outline: • Definition of comprehensive geriatric assessment . • How to prepare for geriatric assessment . • Critical components of geriatric assessment. • Functional assessment. • Cognitive assessment. • Roles of geriatric interdisciplinary team.
A comprehensive geriatric assessment : A comprehensive geriatric assessment : is an interdisciplinary approach to the evaluation of older adults’ physical, psychological, social, and spiritual functioning.
A comprehensive geriatric assessment : These types of assessments are generally conducted in teams that include nurses, physicians, social workers, and therapists that assess and plan care addressing the multiple needs of older adults.
A comprehensive geriatric assessment : A comprehensive geriatric assessment should always involve family members and caregivers, as appropriate.
Preparing for geriatric assessment : • The most effective way to perform the assessment is to make the client comfortable and establish a rapport. • Eliminating noise and promoting attention and concentration will allow clients to answer questions to the best of their ability. • After the examination, the score can be computed and used as a basis for care planning.
critical components of geriatric assessment: There are two critical components of geriatric assessment that must be discussed here: • function • cognition.
critical components of geriatric assessment: • When older adults experience the onset of disease, changes in function and cognition are often the first symptoms.
The presence of cognitive dysfunction should be assessed, because acute decline in cognitive function often signals the onset of physiological disease. • Detection of changes in cognitive function may help the older adult to receive earlier and, thus, more effective disease treatment. • In addition, detection of chronic cognitive dysfunction allows for early planning to assure the safety, high functionality, and optimum quality of life for the older adult.
Function • Functional assessment : • is a systematic attempt to measure objective performance in ADLs, including bathing, dressing, toileting, eating, ambulating, and continence.
Function • An older adult’s ability to independently complete activities of daily living (ADLs) is a benchmark for health. • If an older adult becomes incontinent or unable to bathe themselves, this often requires a change in the level of care. • Moreover, an acute decline in functional status frequently signals the onset of physiological disease among older adults.
Instrumental activities of daily living • Instrumental activities of daily living (IADLs) are the more complex tasks people need for independent living. The IADLs include being able to shop, cook, manage finances, manage transportation, do housework and manage medications.
Significant of assessment of functional limitation • Assessment of functional limitations in older adults is very important for detecting disease and dysfunction, selecting appropriate interventions, and evaluating the results of these interventions. • With the older adult, the ultimate goal is to maintain optimal function and be as independent as possible.
Cognitive assessment • Because altered cognitive status is one of the more commonly occurring symptoms of disease among older adults, cognitive assessment is an essential skill to be acquired by nurses caring for the older population.
Mini Mental Status Examination • There are many instruments that can be used to accomplish this purpose. • One screening tool that has been used successfully to screen for the development of changes in cognitive function symptomatic of dementia is the Mini Mental Status Examination (MMSE)
Mini Mental Status Examination • Based on a 30-point scale, the MMSE measures levels of awareness and orientation, appearance and behavior, speech and communication, mood and affect, disturbances in thinking, problems with perceptions, and abstract thinking and judgment.
Mini Mental Status Examination • The higher the older adult scores, the more intact the cognitive status. • When the scale is 23 or lower, the client has a problem with cognition and needs further evaluation.
The geriatric interdisciplinary team works toward: • promotion and maintenance of functional independence . • assisting the older adult to live independently as long as possible . • preventing hospitalization.