Introduction
Geriatric assessment provides a structured way of identifying health issues and conditions that are potentially preventable to improve quality of the life.
Definition
The geriatric assessment is multidimensional. Multidisciplinary assessment designed to evaluate an older person’s functional ability, physical health, cognition and mental health, and socioenvironmental circumstances for maintaining activities of daily living (ADLs).
Components
- Functional.
- Clinical.
- Nutritional.
- Psychosocial.
Purposes
- To collect valid information regarding the patient.
- To identify the problem.
- To plan appropriate nursing actions.
- To compare the patient’s current health status with the expected health status.
Articles
Preparation of equipment
| Articles | Purpose |
| Otoscope with speculums of different sizes | Aid to visualize ear. |
| Ophthalmoscope | To check visual perception. |
| Percussion hammer | To check deep tendon reflex. |
| Tuning fork | To check hearing. |
| Nasal speculum | To check the nose. |
| Laryngeal mirror | Visualization of the mouth and throat. |
| Tongue depressor | Aids in proper visualization of the mouth. |
| Stethoscope | To auscultate the heart, lung and abdomen sounds. |
| Inch tape | To measure the circumference of the abdomen, waist, and muscles. |
| Lubricant | To aid in performing DRE. |
| K- basin | To discard the waste. |
| Torch | Aids in visualization. |
| Clean gloves | To prevent infection. |
| A bowel with cotton balls, gauze, and swab sticks | To collect smear. |
| Weighing scale | To assess the weight. |
| Under pad | To prevent soiling of linen. |
| Patient gown | |
| Top sheet | To drape the patient as per his or her need. |
| Warm blanket | |
| Screen | To provide privacy. |
| Snellen chart and a book | To assess visual acuity. |
| Chart and pen | To document findings. |
Components of patient ‘s health history
Clinical assessment
Collect history pertaining to;
- Problems at birth, childhood illness, immunization (also includes vaccines for COVID-19) and adult illness.
- Medication (list down all the medications prescribed and illicit medications used by the patient).
- History of usage of OTC drugs (vitamins, herbs and dietary supplements) polypharmacy, and allergies.
- Surgeries or other treatments.
- Current health status (explain according to COLDSPA).
- Habits, sleep and rest, activity, and exercise.
Functional assessment
Assess the functional needs of the patient:
- Perform ADLs: Bathing, brushing, toileting, dreesing , grooming, feeding, fecal and urinary continence, mobility, transfer,and ambulation.
- Instrumental ADLs: Ability to use telephones, shop, do laundry, manage finance, take medications, and prepare meals.
- Vision, hearing, oral health (dentition, ability to chew and swallow,etc.), and gait.
- Family history.
- Self-concept: Determines the way in which a person interacts with others.
- Role-relationship pattern: Family, social and work roles and relationship.
- Sexuality and reproductive pattern.
- Environmental history.
- Spiritual history.
- Social needs (interaction, hobbies).
Nutritional Assessment
- Food habits: Any special diets (e.g., low- salt, low- carbohydrate) or self –prescribed fat diet, intake of dietary fiber, weight loss, and fluid consumption per day.
Psychological Assessment
- Memory and orientation.
- Judgment (decision making).
- Thinking and perception.
Standardized Tools & Instruments
- Katz Index of ADL / Lawton IADL Scale
- Mini-Mental State Examination (MMSE) / Montreal Cognitive Assessment (MoCA)
- Geriatric Depression Scale (GDS)
- Malnutrition Universal Screening Tool (MUST) / Mini Nutritional Assessment (MNA)
- Timed Up and Go (TUG) Test
- Home Safety Checklist (fall risk audit)
Frequency & Follow-Up
- Baseline: at initial geriatric intake or upon major health event
- Ongoing: every 6–12 months or sooner if function or cognition changes
- Transition points: hospital discharge, new diagnosis, change in living situation
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
Stories are the threads that bind us; through them, we understand each other, grow, and heal.
JOHN NOORD
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