Flashcards in Comprehensive Assessment Deck (46)
Define Functional Capacity
Person's ability to perform tasks that are required for living
What are the two key divisions of functional capacity?
1. Basic Activities of Daily Living (ADL's)
2. Instrumental Activities of Daily Living (IADL)
What Katz Index of Independence in ADL score would indicate a highly independent elder?
Score of 6
What Katz Index of Independence in ADL score would indicate a very dependent elder?
Score of 0
List the 5 Instrumental Activities of Daily Living (IADL)
2. Preparing meals
3. Taking medications properly
4. Managing finances
5. Using a telephone
What Scale would you use to assess IADL's?
Lawton Instrumental Activities of Daily Living Scale (9 Q's)
What are the 4 components of the comprehensive geriatric assessment?
1. Functional Capacity
2. Physical Health: Pharmacy
3. Cognition/Mental health
What 5 topics does the physical health component cover?
3. Balance and Fall prevention
4. Fecal and Urinary incontinence
What vitamins/minerals are elderly deficient in?
1. Vitamin A, C, D
What does Nutritional Health Checklist of 0-2 mean? Recommendation?
Re-check nutrition score in 6 months
What does Nutritional Health Checklist of 3-5 mean? Recommendation?
Moderate nutritional risk
Re-check nutrition score in 3 months
See what you can do to improve eating habits and lifestyle
What does Nutritional Health Checklist of 6+ mean? Recommendation?
High Nutritional Risk
Bring checklist to physician or dietician for help to improve nutritional status
What increased risks is low vision associated with?
2. Cognitive decline
Who should have a vision assessment?
2. Cognitive Declines
3. Functional impairment
What are common causes of vision impairment?
3. Diabetic Retinopathy
5. Age-Related Macular Degeneration
What is the 3rd MC ailment in elderly?
At what age do we screen for hearing loss?
What tests do we use to test for hearing loss?
2. Whispered voice test
What is hearing loss associated with?
1. Cognitive decline
2. Functional impairment
4. Social Isolation
5. Poor self-esteem
6. Increased hospitalizations
What Hearing Handicap Inventory score is considered a No Handicap/No Referral
0-8= 13% probability of hearing impairment
What Hearing Handicap Inventory score is considered a mild-to-moderate handicap/referral?
10-24= 50% probability of hearing impairment
What Hearing Handicap Inventory score is considered a severe handicap/referral?
25-40= 84% probability of hearing impairment
When should you refer your patient to a otolaryngologist?
If they fail the screening test
What is the TOC in hearing loss?
What are the complications of urinary incontinence?
3. Decubitus ulcers
4. Renal Failure
5. Increased mortality
What is the key deciding factor in urinary incontinence?
Nursing home placement
What is the leading cause of hospitalizations and injury-related death in 75+?
What is a Normal Time for the Get up and Go test (Tinetti Balance & Gait Evaluation)
What is a Fairly Mobile time for the Get up and Go test
What is a Variable Mobile time for the Get up and Go test
What is a Functionally Dependent in Balance and. Mobility time for the Get up and Go test
30 seconds or more
How can older persons reduce their fall risk?
2. Home Hazard Assessment
3. Remove Psychotrophic meds
What is the USPSTF osteoporosis screening recommendation in women?
Screen women 65+ with DEXA of femoral neck
-2.5 or lower
-1 to -2.5
What percentage of hospital admission in older people is secondary to drug ADE's?
How do older adults present with depression?
1. Somatic complaints
2. Cognitive/functional problems
3. Sleep disturbances
What screening can you use to easily identify pt's @ risk for depression?
Two Q screening
1. Bothered by feeling down, depressed, or hopeless?
2. Little interest or pleasure in doing things
If the patients has a positive screen to both Q's, what should you follow-up with?
7 additional Q's to complete Patient Health Questionnaire (PHQ-9)
PHQ-9 Score for Minimal Depression
PHQ-9 Score for Mild Depression
PHQ-9 Score for Moderate Depression
PHQ-9 Score for Moderately Severe Depression
PHQ-9 Score for Severe Depression
What is a quick initial screening you can use to assess for dementia?
Mini-Cognitive Assessment Instrument: 3 Q's
1. Repeat 3 unrelated words
2. Draw clock
3. Repeat 3 words from step 1
*One point for each item that is recalled correctly