Question

Describe the elements of a comprehensive health assessment of a geriatric patient. What special considerations should the nurse keep in mind while performing this assessment?

minimum of 300 words excluding your reference citation 2. need to use two peer-reviewed/scholarly resources to support your response 3. at least one in-intext citation

Answer 1

In population of every age group, assessment always serves as a medium to identify the existing problem that is signs and symptoms of presence of disease and to initiate treatment and prevention at an early stage. Likewise among geriatric also, the comprehensive assessment benefits in tracing these signs and symptoms of disease at an early stage so that clinicians can manage these conditions and prevent or delay its complications.

The geriatric people suffer may many conditions that have its major impact on the quality of life and disability. The conditions are collectively called as geriatric syndrome. Geriatric syndrome is best identified by a geriatric assessment. These conditions include cognitive impairement, dementia, incontinence, malnutrition, falls,gait disorders, pressure ulcers,sleep disorders, sensory deficits, fatigue and dizziness.

A comprehensive geriatric assessment is a multidisciplinary diagnostic and treatment process to identifiy the medical, psychosocial and functional disabilities of a geriatric patient that helps to develop an integrated plan to maximize the overall health will aging. The health care of the geriatric does not get finished with the medical management but it also includes evaluating multiple issues that includes social, economical, psychological,physical,cognitive, environmental, financial and spiritual components that effects health of older adults. These assessment is initiated at the primary care level and may be doen in different settings.

The major elements of components of comprehensive geriatric assessment are:

1. Functional status: It is a very important step to evaluate the functional capacity of the older adult i.e the ability to perform his daily necessary znd desireable activities. These includes activities of daily living which may be basic, intermediate and advanced activities of daily living. Example: bathing, tioleting, grooming,feeding, transfering, shopping, performing housework, using telephone, driving, taking medications, handling finance, ability to use internet, ability to keep schedule of his activities.Gait speed is another factor that helps to evaluate one's functional ability.
2. Falls/ imbalance: Assessment of fall risk is very crucial as the older adult above 65years of age is vulnerable and at risk of fall. Timele assessment will help to prevent patient harm resulting from falls.
3. Cognition: The older adults often suffer from the problem of cognitive impairementm like dementia. The assessment of cognitive impairement may require further mental health examination, neurophysiological testing etc.
4. Mood disorders: the elderly adults often suffer from mood disorders especially depression which results in unnecessary suffering, impaired functional ability, increased mortality and increased use of health resources.
5. Polypharmacy: The elderly adults are prescribed multiple medications in order to treat various ailments which may precipitate drug-drug interaction. So a detailed review of the medications is a must in every visit.
6. Social and financial support: Assessing the social and financial status of the older adult will help to determine if the patient can stay in the home or needs placement in an institution.
7. Goals of care: This focus on the future status of health mainly social and functiona goals assumes priority. These goals may be patient centric and individualized and includes both long and short term goals.
8. Advance care preference: It allows the geriatric to make his own treatment choices if his cognition is patent.

There are other additional components which are important in geriatric health assessment like nutritional and weight change, urinary and fecal incontinence, sexual function, vision and hearing,dentition, living situation and environment,spirituality.

References:

• Katherine T Ward, David B Reuben, " Comprehensive geriatric assessment", June 19, 2018.
• Darryl Wieland, " Comprehensive geriatric assessment ", Dec 2003, Volume 10, No: 6
• Bassam Elsawy, Kim E.Higgins, " The Geriatric Assessment" 2011 Jan 1; 83(1): 48-56