Flashcards in Lecture 2- Comprehensive Geriatric Assessment (CGA) Deck (15):
What is the value of CGA
- Improves function
- Improves Health Quality of Life
- Decrease Hospitalizations
How to conduct office-based assessment (what should you do?)
- Functional assessment by observation
- Directed medical history and physical examination
- Assessment instruments/tools
- Psychological assessment
Functional assessment by observation
- Did the patient fill out the questionnaire?
- Observe the patient walk and getting on exam table
- What kind of detail does the pt. give you in a history?
What to include in Directed medical history and physical exam
- IADL (instrumental activities of daily living)
- Gait and balance/feet
What are the IADL's, and when do you start asking about them?
- Community dwelling, and 65 and older- begin asking
- Follow up at 1,3,5 yr....
The four IADLS
What percentage of the elderly have a nutritional disorder?
Serum _______ and _______, although nonspecific, are prognostic factors for mortality
Weight loss of more than _______ total body weight in the past 6 months is a RED FLAG
How do you test gait, balance, feet in the CGA?
- The get up and go test!
- walk 10 ft and return to chair
- Fail if it takes more than 20 seconds.
How should you do psychosocial assessment in a CGA?
- Cognitive Testing
- Mood/Depression testing
- be familiar with the risk factors for depression- esp. social isolation.---- does this patient apply to any of those?
2 geriatric screeners for depression
- Geriatric Depression Scale (GDS)
- Patient Health Questionnaire (PHQ-9)
What can you use for Cognitive Function assessment?
- Folstein mini-mental state examination (MMSE)
- Montreal cognitive assessment (MOCA)
- Clock draw test (CDT)
- Verbal fluency (VF) or animal naming
- Mini-Cog (3 item recall test and clock draw)
What can you use for palliative/performance status assessment?
-Karnofsky scale (0-100 scale, with normal being 80 and above)
- Palliative Performance scale, version 2 (PPSv2)
- A multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of an older adult in order to develop a coordinated plan to maximize overall health with aging