Comprehensive Geriatric Assessment Flashcards
What is the cause of frailty in the elderly?
An age related decline which leads to:
> Impairment of individual organ function
> Breakdown of the complex interplay between organ systems (dyshomeostasis)
What is frailty?
Increased risk of death or debility following exposure to an environmental stressor
A reduced ability to withstand illness without loss of function
Illness trajectory - frailty?
1) Triggering event
2) Decline
3) Crisis
4) Admission (Stable)
5) Reablement (Improvement)
Typical ‘syndromes of presentation’?
> Falls
Immobility (‘off legs’)
Functional decline (‘not coping’)
Delirium
What is the issue surrounding dyshomeostasis in geriatrics?
Disrutpion in multiple body systems thus multiple health domains
What is the WHO definition of health?
‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’
Examples of the different health domains?
Medical Psychological Functional Behavioural Nutritional Spiritual Environmental Social Societal
Comprehensive Geriatric Assessment?
1) Process to assess and manage illness in older people
2) Determine what the problems are
- Multiple medical problems present at once
- Multiple health domains affected
3) Determine what we can reverse and what we can make better
4) Produce a management plan
Psychological aspects of geriatric medicine?
> Mood
- Low mood
- Anxiety
> Confidence
- ‘fear of falling syndrome’
> Cognition
- Delirium
- Dementia
Functional aspects of geriatric medicine?
> Mobility
- Transfers
- Mobilising
> Activities of Daily Living
> Community Living Skills
Medical aspects of geriatric medicine?
> Pathological – ‘disease’
> Physiological – ‘normal ageing’
> Reversible versus Non-reversible
> Multiple concomitant problems
> Iatrogenic harm
> Infection
> Majority of modern medicine is treating/ ameliorating chronic disease (or acute exacerbations of chronic disease)
> Few things in medicine are ‘curable’
Behavioural aspects of geriatric medicine?
> Behavioural determinants of ill health - Unhealthy eating/smoking/drinking
> Activities/Pastimes
> Occupation
Nutritional aspects of geriatric medicine?
> Poor nutrition leads to ill health
> Ill health leads to poor nutrition
> MUST screening tool
Spiritual aspects of geriatric medicine?
> How do I fit in to the bigger picture?
> What’s important to you?
> How do you like to project your self-image?
> What’s the meaning of your life?
Environmental aspects of geriatric medicine?
> Housing
Heating
Sanitation
Adaptation
