Comprehensive Geriatric Assessment and the Interprofessional Geriatric Team

Author: Nasiya Ahmed, MD & Kathleen Pace Murphy, PhD, MS

Key Points

The comprehensive geriatric assessment (CGA) assesses a patient's physical, cognitive, psychological, social and functional status. It is a benchmark that clinicians utilize to assess a patient, determine the plan of care and evaluate outcomes of the plan of care. 

The comprehensive geriatric assessment is highly effective for diagnosing and treating geriatric syndromes and co-morbid conditions in older adults. It provides information to understand the impact of illness; assess quality of life; identify needs; and, regulate progress. 

Functional decline, a component of the comprehensive geriatric assessment is often the first sign of acute illness. Functional impairments are prevalent among older patients, and can be improved with early recognition and treatment.

The World Health Organization (2010) defined Interprofessional team (IPT) collaborative practice as healthcare providers from a variety of professional backgrounds working together with patients, families, caregivers, and communities to deliver the highest quality of care.

Patient centered care is the goal of Interprofessional team collaborative practice (Interprofessional Education Collaborative, 2011).

Interprofessional team collaborative members interdependently and collectively complete a comprehensive geriatric assessment 

 

Overview

The foundation of geriatric medicine is the comprehensive geriatric assessment (CGA).

For older adults, the health care needs extend beyond the traditional medical management of illness. Older adults, particularly the frail elderly, require evaluation of multiple issues including physical, cognitive, affective, social, financial, environmental, and spiritual components that influence an older adult's quality of life.

It is strongly recommended that a multidimensional IPT complete the CGA diagnostic process, which can be used to provide targeted interventions based on the assessment findings.

A CGA differs from the standard patient evaluation in three distinct ways:

  1. It focuses on older adults with complex problems;
  2. It emphasizes functional status and quality of life; and,
  3. It involves an interprofessional team of health care providers.
The assessment components of the CGA include social activity, fall risk, vision/hearing, medication review, dentition, functional status, living situation, nutritional assessment, financial situation, cognitive ability, environmental assessment, affect/mood, spiritual belief, sexual function, urinary continence, and advanced care preferences. 

 

Assessment

The following is a list of commonly used assessment tools.

Nutrition Mini Nutritional Assessment
Functional Status Activities of Daily Living (ADLs) and 
Instrumental Activities of Daily Living (IADLs)
Cognitive Status Saint Louis University Mental Status (SLUMS), Confusion Assessment Methods (CAM)
Affect/Mood Geriatric Depression Scale
Medication Review Review prescription and over the counter medications every visit. In-depth review for: >5 prescription drugs or >3 over the counter drugs.
Environmental Assessment Home Safety Evaluation
Fall Risk Get Up and Go

 

References

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