Geriatric Assessment

Geriatric assessment is a multidisciplinary and multidimensional assessment that is focused on evaluating the older people social environment circumstances, mental health, cognition, physical health and functional abilities (Elsawy & Higgins, 2018).

This approach underscores an in-depth review of prescription of herbal products, vitamins and over the counter drugs and extends to examine the immunization status of the individual. The assessment is important because it aids in the diagnosis of medical conditions, planning the treatment and ensures a routine follow up, managed and coordinated care, and assesses the long-term needs as well as optimal placement of the patient (Elsawy & Higgins, 2018).  

Geriatric assessment commences when the clinician detects potential problems from the patient such as incontinence, immobility, falls, and confusion (Rosen & Reuben, 2011). More so, the psychological and social factors may also mask the classical disease presentation in the patient. Form this information the clinician is able to formulate an effective patient evaluation plan for Mrs. Roberts. 

Considering that the patient has multiple concerns, rolling assessment tool over several visits is considered. The assessment takes place in the healthcare clinic environment and Mrs. Roberts is accompanied by one of her family members, in this case, her daughter.

Having a family member it is important because her declining visual ability does not allow her to drive. Also, the fact that she cannot maintain eye contact implies that the presence of a family member is vital to ensure that she gives an accurate response.

The assessment tool focuses on functional ability to assess if Mrs. Robert is able to undertake activities that are required for a living. This starts with reviewing two critical functional ability including; instrument activities of daily living (IADL) and activities of daily living (ADL) (Elsawy & Higgins, 2018).

ADL underscores activities such as; bathing dressing, eating using the toilet, transfers between bed and chair and the ability to control bowel and bladder functions. IADL is focused on assessing the patient ability to use a telephone, manage finances, a proper taking of medication, driving, preparing meals, and doing housework (Elsawy & Higgins, 2018).

Functionality ability will be tested by asking the patient to do simple tasks such unbuttoning and buttoning a shirt, writing sentences using a pen, and putting on and off a pair of shoes.   

The clinician should assess the physical health of the patient such as their medical history which underscores demographic data, social and family history, current and past medical problems, current illness, main problem and system review (Denson, Manzi, Foy, Giever & Rehm, 2014).

This assessment should be specific to the old person and should include specific topics such as; polypharmacy, osteoporosis, fall and balance prevention, urinary and fecal continence, hearing, vision, and nutrition.  

The next step is to screen for diseases, this is because the aging process is characterized by declining physiological functions (Denson, Manzi, Foy, Giever & Rehm, 2014). This should be done according with the family preferences and one should weigh the potential harm of the patient. Geriatric Assessment

itionally, nutrition assessment is important to evaluate for inadequate micronutrient intake which is common among the older adults. This includes patient nutrient history, usual food intake, and physical examination for over or under consumption of nutrients and specific laboratory tests (Elsawy & Higgins, 2018).   

Assess for vision impairment as Mrs. Roberts is unable to drive herself and cannot maintain eye contact. These impairments include; macular degeneration which is associated with age, cataracts, diabetic retinopathy, glaucoma, and presbyopia (Elsawy & Higgins, 2018).

Hearing impairment which is common among the old people, this is because treating hearing impairment reduces hearing loss and improves person’s daily functionality (Elsawy & Higgins, 2018). Osteoporosis assessment which causes spontaneous fragile fractures, this is diagnosed by dual-energy X-ray for lumbar spine, femoral neck, and the entire hip (Rosen & Reuben, 2011). 

Cognition and mental health assessment to evaluate for depression, and dementia, this screening is important to analyze increasing memory loss such as failing to attend appointments, and disheveled.

Also, dementia helps in the diagnosis of irritability and depression at their early stages. In addition, assess the social environment circumstances to discern her social interaction, loneliness, and determine her social interaction network, environment safety, special needs and the available support systems.