NURS 306: Week 7 - Comprehensive Geriatric Assignment

What is a comprehensive geriatric assessment (CGA)?

A systematic, multidimensional approach to assessing frail older adults to develop a coordinated and integrated plan for treatment and follow-up.

Individuals of the same chronological age can vary differently in terms of physiological age (True/False).

True

A CGA is not . . .

- A single assessment tool or checklist

- A one-time evaluation with no follow-up

- Focused only on disease

- A replacement for professional judgement or patient involvement

What are all of the CGA domains?

- Medical/systems review

- Functional assessment

- Cognition and mental health

- Social//environmental support

- Nutrition and continence

- Falls and safety

- Quality of life/goals of care

What is assessed in the medical/systems review of the CGA?

- Chronic and acute medical conditions

- Medications

What are some examples of tools used for a medical/systems review?

- Best possible medication history (BMPH)

- Medication review

- Standardized symptom checklists

- Snellen eye test

- Audiometry

What is assessed in the pain section of the CGA?

- Acute and chronic pain

- OPQRSTUV

- Impact of pain in daily life

What are some tools used to assess pain in older adults?

- Numeric rating scale (NRS)

- Verbal descriptor scale (VDS)

- Pain assessment in advanced dementia (PAINAD)

- Pain assessment checklist for seniors with limited ability to communicate (PACSLAC)

- Brief pain inventory

- Observational cues

What is assessed in the functional assessment of the CGA?

- Activities of daily living (ADLs)

- Instrumental activities of daily living (IADLs)

- Mobility

What are activities of daily living (ADLs)?

Basic self-care tasks, including bathing, dressing, and eating.

What are instrumental activities of daily living (IADLs)?

Complex daily tasks necessary for daily living, including managing finances, transportation, and cooking.

What is assessed in cognition section of the CGA?

- Screens for memory, attention, language, and executive function

- Detects delirium, cognitive impairment, and dementia

- Identifies cognitive deficits

What are some examples of tools used to assess cognition in older adults?

- Mini-cog

- Montreal cognitive assessment (MoCA)

- Mini-mental state exam (MMSE)

- Rowland universal dementia assessment scale (RUDAS)

What are 2 parts of the mini-cog?

- Word recall

- Clock drawing

What is assessed in the mental health section of the CGA?

- Screens for depression, anxiety, stress, grief, and apathy

- Past psychiatric history

- Current coping mechanisms

What are some tools used to assess mental health in older adults?

- Geriatric depression scale (GDS)

- Patient health questionnaire (PHQ-9)

- Cornell scale for depression in dementia

- Informant interviews or caregiver questionairres

What is assessed for the social/environmental support section of the CGA?

- Family, caregiver, and community support

- Living situation, accessibility, and safety

- Cultural, financial, and legal considerations

What are some tools used to assess social/environmental support in older adults?

- Social support questionnaires

- Home safety checklists

- Resource mapping

What is assessed in the nutrition section of the CGA?

- Weight changes, appetite, and hydration status

- Swallowing difficulties and dietary restrictions

- Links to functional ability, immunity, and recovery

What are some tools used to assess nutrition in older adults?

- Mini nutritional assessment (MNA)

- 24-hour dietary recall

- Food frequency questionnairres

What is assessed in the continence section of the CGA?

- Frequency, urgency, nocturia, and urinary incontinence

- Constipation, diarrhea, and difficulty with toileting

- Impact on independence, skin integrity, and psychosocial wellbeing

What are some tools used to assess continence in older adults?

- Voiding diary

- Bowel diary

- Continence assessment checklists

What is assessed in the falls and safety section of the CGA?

- History of falls, near misses, and injury

- Intrinsic and extrinsic risk factors

- Home hazards, mobility aids, and safety interventions

What are some tools used to assess falls and safety in older adults?

- STEADI

- TUG

- Home safety assessment checklists

What is assessed in the quality of life section in the CGA?

- Overall well-being and satisfaction

- Physical, psychological, social, and functional domains

- Impact of health status and intervention on daily life

What are examples of tools used to assess quality of life in older adults?

- SF-36 or SF-12 health survey

- EQ-5D

- WHOQOL-BREF

- Older people's quality of life questionairre (OPQOL)

What is assessed in the goals of care section of the CGA?

Patient values, preferences, and priorities

What are some tools used to assess the goals of care section in the CGA?

- Goal attainment scaling (GAS)

- Advance care planning templates

- Structured patient-centered interview guides

What are the most common cancers in older adults?

- Lung

- Breast

- Prostate

- Colorectal

- Hematological

What are common types of local therapy used to treat cancer?

- Surgery

- Radiation therapy

What are common types of systemic therapy used to treat cancer?

- Chemotherapy

- Hormone therapy

- Immunotherapy

- Targeted therapy

What are some common effects of cancer treatment?

- Anemia

- Fatigue

- Cognitive impairment

- Dietary challenges

- Loss of muscle mass and strength

- Dehydration

- Osteoporosis

- Neuropathy

- Pain

- Emotional stress

- Anxiety

- Depression

- Decreased physical activity and mobility