...Comprehensive geriatric assessment is defined as a multidisciplinary diagnostic and treatment process that identifies medical. Psychological and functional limitations of a frail older person in order to develop a coordinated medical management of illness. It requires evaluation of multiple issues including physical, cognitive, affective, social, financial, environmental and spiritual components that influences an older persons by a team of health professionals may identify a variety of treatable health problems and lead to a better outcome. However, it is initiated through the primary care clinician or by a clinician caring for a patient in the hospital setting. The content of assessment varies depending on the settings of care. CGA is not available in all settings due to issues related to the tie required for evaluation, need for coordination of multidisciplinary specialties and lack of reimbursement for some components. Overall elements of comprehensive geriatric assessment includes: Physical Health-This focuses on medication use and the risk for malnutrition, falling, incontinence and immobility. The physical examination seeks to identify specific diseases or conditions for which curative, restorative, palliative or preventive treatment may be available. Special attention is directed towards visual or hearing impairment, nutritional status and conditions that may contribute to frailty and falling or difficulty in ambulation. Mental Health-Cognitive, behavioral and emotional...
Words: 623 - Pages: 3
...Falls are very common in the geriatric population. They are the leading cause of injury and death by injury in adults over the age of 65 years (Lee, 2013, p.37). Falls can have devastating results in the geriatric population. Fear of falling is a defined geriatric syndrome that may contribute to further functional decline in an already frail patient. When people experience something unpleasant, their natural response is an aversion to that experience. People may begin to limit their activities after a fall or as they become weaker and less agile with increasing age. This leads to a more sedentary lifestyle and physical atrophy, which further predisposes them to falls (Lee, 2013, p.37). According to Al-Aama (2011): A fall is a complex multifactorial phenomenon. In order to understand the mechanism of falls, it is essential to understand the prerequisites of normal gait. Essential substrates for a normal gait include fine neural networks such as the cortical–basal ganglia loop and the basal ganglia–brainstem system, exquisite musculoskeletal structures with appropriately regulated muscle tone, and proper processing of sensory information (p. 772). A fall in the geriatric population could be the result of various long-term or short-term factors. A short-term factor could include an acute illness or an adverse drug reaction. Normal gait and balance requires freely moving joints; muscles contracting at the right time with the appropriate strength; and accurate visual, vibratory...
Words: 1309 - Pages: 6
...Assessment on a geriatric patient is usually different from standard medical evaluation of other patients. For the elderly patients, especially those that are really old. General assessment like the physical and history-taking might not be done at the same time because patient becomes tired easily. The elderly usually have multiple health issues which requires the use of many drugs which is also called polypharmacy. The elderly are best evaluated using a comprehensive geriatric assessment, which includes evaluation of function and quality of life usually by an interdisciplinary team. While assessing a geriatric patient, the nurse should consider that at this point in their lives a lot is going on, there is degenerative changes, multiple disorders, caregiver problems, missed or delayed diagnosis. On average, elderly patients have 6 diagnosable disorders, which their primary care giver might be unaware of A disorder in one organ system can weaken another system, exacerbating the deterioration of both and leading to disability, dependence, and, without intervention, death . The nurse should also pay particular attention to certain common geriatric symptoms (eg, delirium, dizziness, syncope, falling, mobility problems, weight or appetite loss, urinary incontinence) because they may result from disorders of multiple organ systems. Occasionally, problems of elderly patients are related to neglect or abuse by their caregiver (see Elder Abuse).The nurse also should consider the possibility...
Words: 320 - Pages: 2
...project. The two site coordinators were responsible for preparing and coordinating the ethical review applications and letters of support. The team decided to use the existing practices of community service providers. To facilitate referrals of participating patients, the team first identified the existing service pathways. The hospital medical director distributed an overview document to inform emergency department physicians of the project, and the clinical nurse specialist reviewed the referral process, protocols and documentation with nursing staff. ore than ever, health-care providers need to communicate with each other to stay informed about the services clients receive. Working in collaboration is essential to the delivery of effective, efficient and timely care (D'Amour, Ferrada-Videla, San Martin Rodriguez, & Beaulieu, 2005; Interprofessional Care Steering Committee, 2007). We all had roles on the Geriatric Emergency ManagementFalls Intervention Team (GEM-FIT) project, which was aimed at evaluating an alternative service-delivery pathway to reduce the number and consequences of falls in adults aged 65 and older who presented to an inner-city hospital emergency department. The project was based on the Falls Intervention Team (FIT) study, which had evaluated a best practice, multifactorial fall-prevention program for community-dwelling older adults (Baycrest Centre for...
Words: 3372 - Pages: 14
...Jessica Rose December 13, 2015 Student ID# 277419 XTT Task 1 BSN to MSN A Currently in my facility, we do not have a policy regarding geriatric and/or demented patients and pain control. I believe this needs to be changed because although we have an initial assessment protocol, we do not have any kind of protocol to control a geriatric or demented patients pain. Since demented patients are quite often left unable to communicate their feelings, I believe there would be, less adverse effects and better patient outcomes for this group of people and better satisfaction with their families. B There are many people associated with proposing the change within the facility. First would be to go through the assistant nurse manager and nurse manager who would then bring the proposal to the nursing and medical directors for the ER. The ANM and NM would have to decide whether the proposed change would be beneficial for the patients and their outcomes and do further research which they would then propose to the directors. From there, they would decide whether the research was sufficient enough to implement a change. C Full APA citation for at least 5 sources | Evidence Strength (1-7) and Evidence Hierarchy | 1. H., Bell, J., Karttunen, N. M., Nykänen, I. A., M., & Hartikainen, S. A. (2013). Analgesic Use and Frailty among Community-Dwelling Older People. Drugs & Aging, 30(2), 129-136. doi:10.1007/s40266-012-0046-8 | 2 and Experimental | ...
Words: 2413 - Pages: 10
...A comprehensive assessment of the geriatric patient is very important for many reasons and the first being a baseline if nothing else. Today when we use the term geriatric or elderly this does not mean that this person is in a wheelchair or walking with a walker, it is in regards to where they are in their lifespan. Therefore a comprehensive assessment for one may be totally different for another. The healthcare provider needs to keep in mind that this could make the geriatric patient have feelings of hopelessness and helplessness. Comprehensive geriatric assessment (CGA) should being with collecting a health history by interviewing the patient and their family members if needed. The healthcare provider wants to promote an efficient exchange of information and build a rapport with the patient and family. The healthcare provider needs to speak clearly and minimize distractions, give a brief overview of what you will be doing (Lynder, 2011). The CGA can also be done with an interdisciplinary team (Hirth, 2003). The healthcare providers are looking for current and past medical history. A list of current prescription and non-prescription medications are to be recorded. Next we can move to the physical examination, head-to-toe assessment. The healthcare provider would start by assessing: * The skin, looking for moles that are dark or irregular in size, bruising and elasticity of the skin. Checking for pressure ulcers or sores that are not healing properly (Lynder, 2011). ...
Words: 567 - Pages: 3
...Major depression is a chief health concern in the geriatric population, with up to 20% of this population experiencing some form of depression (Frank, 2014, as cited in Harrigan & Lyons, 2015). The issue of depression in the older adult population is especially complex as causes and outcomes are inter-related and interactive; nurses must consider many variables when assessing and carrying out care for these individuals. Untreated depression can have significant consequences such as poor pain control, poor recovery from illness or surgery, cognitive deficits, increased risk for falls, impaired ability to carry out ADLs leading to a loss of independence, worsening physical health problems, substance use, social isolation, and suicide (Harrigan...
Words: 779 - Pages: 4
...Chapter I THE PROBLEM AND ITS BACKGROUND Introduction Depression is an illness that involves the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression (Dryden-Edwards, et. al., 2010). Animal-assisted therapy (AAT) is a relatively new field of study, although the human-animal bond has existed for thousands of years. AAT is a type of therapy that involves animals as a form of treatment. The goal of AAT is to improve a patient’s social, emotional, or cognitive functioning. Animals can also be useful for educational and motivational effectiveness for participants (American Humane Association, 2010). Animals are tools for therapy because they can make people feel safe and loved when they have been deprived of social interaction or hurt by other people. They do not communicate with words, and so patients afraid of approaching people can comfortably approach an animal. For the elderly, the companionship of owning a pet can be valuable, especially if they do not have any family or friends nearby to visit. The pet loves them i[n an...
Words: 1232 - Pages: 5
...fact that one has to get older. In this time and age, a lot of negative things are associated with aging. One of those negative associations is geriatrics diseases. The younger generation observes the older generation depressed and not the same old happier person they once were before geriatrics diseases start to set in. Although, not all geriatric disease are curable, it better to be aware. So therefore it good to learn about the definition of geriatric disease and the people at risk, treatments and what happens if some diseases go uncured and the statistics of people with the disease and the occurrence of the disease. The topic of geriatric diseases is not fully understood, so the definition needs to be elaborated. According to the medical dictionary the term geriatrics means “the department of medicine dealing especially with problems of aging and diseases of the elderly”. The world dictionary defines disease as “any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown.” So in other terms geriatric disease can be defined as an interruption of normally functioning body part, organ and or system with problems of the elderly. The most common types of geriatrics disease are arthritis, cardiovascular and osteoporosis. Arthritis is the inflammation of the joints. The cause of arthritis is normal wear and...
Words: 1645 - Pages: 7
...© Mizukami, Airisu C. IV- PT * CHAPTER 10 * FUNCTIONAL ASSESSMENT USED WITH OLDER ADULTS Health in Old Age * Is a complex, elusive concept. * Experiencing normal developmental age changes such as gradual changes in endurance, vision, hearing & reflex timing. * Some problems in old age due to a long-term disuse of physical & mental abilities: * Back problems due to lifelong postural habits or long use of sagging mattress. * New widow may struggle to make independent decisions regarding home maintenance. * Traumatic injury may occur such as hip fracture or CVA. * Trauma, whether physical or psychological, occurs in conjunction with chronic & acute disease, normal age changes & changes due to misuse or disuse. * Snow & Rogers describe this complex combination of normal & pathologic changes in old age as a “delicate balance” of adaptation. * The multi-dimensionality of health in old age is reflected in current trends toward multi-dimensional assessment instruments & Geriatric Evaluation Units. * Most multi-dimensional assessments include physical health, functional ability, psychologic health & social parameters. Functional Assessments Used in Occupational Therapy Physical Self-Maintenance Scale & Instrumental Activities of Daily Living Scale * The scales represent measures of two level function, competence, the scales represent measures of two levels of function, with the IADL requiring...
Words: 954 - Pages: 4
...Integrative Final Project Evon Stevenson CCMH 535 June 9, 2015 Dr. Robin Switzer Integrative Final Project Depression is the fourth leading cause of the worldwide disease burden, and approximately one in four elderly persons may suffer from depression or depressive symptoms (Glasser, Vogels, & Gravdal, 2009). It is a common and disabling disorder that goes undetected, causing unnecessary suffering (Almeida, & Almeida, 1999). This final project will evaluate a new instrument designed to assess depression in adults, ages 65 and older. Research will also be done on different assessment procedures to determine if Emily is clinically depressed or suicidal. Finally, ethical considerations and practice guidelines will be discussed in how to work with Emily and her family. The new instrument is called the Depression Inventory for the Elderly (DIE), it is a self-administered inventory, there are 90 items relating to such depressive symptoms as withdrawal, depressed mood, feelings of guilt and worthlessness, difficultly making decisions, vegetative functions, self-evaluation and interpersonal behaviors. The test takes 35 minutes to administer. The scoring uses a five-point scale of distress ranging (0-4), from “not at all” (0) to “extremely” (4). DIE yields raw and T scores for the Total Score and Primary Dimension Scores. The results are hand scored; T scores above 65 on the Total Score and the Primary Dimensions are considered in the “clinical range.” The normative...
Words: 1397 - Pages: 6
...IN AMERICA The elderly population in the America is expected to approximate to rise to 70 million by the year 2030. To make sure our elderly population get optimal health outcome for our older adult, we as health care should be familiar with geriatric health problem and demonstrate proficiency in caring for our older adult clients. If we as health care professional is proficiency in assessing our geriatric client this will reduce their hospitalization rate and from accurate assessment server as the foundation for age appropriate nursing care Obtaining history from elderly clients will most time include a family member this will help in focusing on the areas of concerns doing the assessment...Before obtaining the health assessment you as an health care professional has to develop a rapport with the client. Speak clear, slowly, appropriately, look directly at them, and put at easy by explain what you will be doing, the reason and give a brief over view of the procedure before you proceed. The data collected will have to be subjective which will include the past history and present, which will be their complaint for seeking care .In preceding to collecting the health history and assessment ask the client about past medical and surgical history that require hospitalize in the past. Assessment should include neurologic disorder and medical history like diabetes mellitus, cancer, respiratory, cardiac, injuries, and falls. Be sure to also document all prescriptions...
Words: 570 - Pages: 3
...Needs Assessment Process Dear Sir or Madam, Thank you for looking into the possible needs that can be used at your facility based on my experience as a public health nurse. The steps I would take in order to assess this population are by using the nursing process. “In practice, the assessment, diagnosis, outcomes identification, and planning steps may take several months are an essential precursor to the action phase of the process” (Smith & Bazini-Barakat, 2003, p. 47). This essential tool used in nurse’s daily lives can be used to determine the needs of the geriatric community at the Centerville Area Agency. I will assess, diagnose, plan, implement, and evaluate. In order to assess the population in question I must evaluate data collected during a quantitative and qualitative study. A survey will be done by each individual member about services they wish should be included to better their healthy lifestyle. A survey also will be done to obtain information about how they remain hydrated and tools used. This quantitative study will provide information about how to tackle the goal at hand which is decreasing the incidence of dehydration in the elderly greater than 65 years of age. Also, a qualitative study would be done to interview patients and obtain firsthand information about how they remain hydrated and what can they do to improve on hydrating themselves. “..qualitative research will find a route to the goal of influencing practice” (Morse & Clark, 2010...
Words: 884 - Pages: 4
...Assessment of Families with Heritage Assessment Tool Grand Canyon University September 2, 2014 Assessment of Families with Heritage Assessment Tool Each country has a different tradition, culture, customs and anindividual’scultural legacy plays a very important part in upgrading the health of that person. According to various sources, United States will observe an immense increase in mixture of cultures in the 21stcentury. Nurses should have a proper knowledge about the patient’s health who belonged to various cultures, and their social needs, in order to enrich their life’s value and the protection of health.Each patient will have different beliefs of their well-being and nurses should be able to recognize, evaluate and work with conventional health habits used by patients of all cultures A teaching method that endorse cultural skills can bedeveloped by educating nursing students about patients heritage evaluation and tradition (Toddmckee, 2012). The heritage assessment tool aids to differentiate various customs and culture of different societies. The main aim of this paper is to apply the heritage assessment tool to evaluate the requirements of a person and his health preservation, assertion, and renewal. In this paper, evaluation of three families, their family background, their culture and tradition is been discussed. Usefulness of Applying Heritage Assessment Tool The purpose of this Heritage Assessment tool is to provide awareness to students which will help them to understand...
Words: 1641 - Pages: 7
...is aimed at targeting services for certain socioeconomic characteristics such as gender, age, or cultural/ethnic background (Anniston, 2012). Target Marketing Woman’s Health This facility has implemented several initiatives over the last decade which forms their strategies that target women. There is a lack of focused care for women in the Hampton Roads region and Sentara has put itself into a position to market and fill this deficiency. It has become increasingly relevant to the marketing team at this facility because capturing the female patient also means influencing the vast majority of health care decisions made for families and women use health services more frequently than men (Anniston, 2012). Most women are dissatisfied with how they receive care, which is often in settings that does not support the unique aspects of care for women (Milliken, 2011). Significant opportunity exists to develop services targeting women, and even to certain age specific groups within this population making meaningful distinction in the marketplace, improving quality of care, and increasing patient satisfaction. These opportunities can range from focused niche service development to comprehensive approaches that incorporate a wide range of programs. Geriatric Patients Sentara Norfolk General Hospital has also recognizing the...
Words: 884 - Pages: 4
