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2 - Assessment of the Older Patient

Published online by Cambridge University Press:  19 May 2010

Christine Arenson
Affiliation:
Jefferson Medical College, Philadelphia
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Kenneth Brummel-Smith
Affiliation:
Florida State University
James G. O'Brien
Affiliation:
University of Louisville, Kentucky
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University, Washington DC
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Summary

Function is the filter through which physicians and others caring for older patients must view them to provide optimal care. Assessing function is necessary for a number of reasons – older adults are more heterogeneous in their functional capacities than younger adults, functional capacity correlates highly with quality of life, and function in and of itself is an important outcome in older patients. Functional status is also an important predictor of outcomes, such as mortality and institutionalization, in a variety of settings, and changes in functional capacity frequently signal changes in an individual's health. Unfortunately, physicians are frequently unaware of or underestimate their patients' functional limitations. Limiting the approach to older patients to a biomedical or even biopsychosocial approach is likely to result in care that at best fails to meet the needs of an older patient, and at worst may cause harm.

COMPREHENSIVE GERIATRIC ASSESSMENT

Comprehensive geriatric assessment (CGA) is “a multidisciplinary evaluation in which the multiple problems of older persons are uncovered, described, and explained, if possible, and in which the resources and strengths of the person are catalogued, need for services assessed, and a coordinated care plan developed to focus interventions on the person's problems.” The goals of CGA are to improve diagnostic accuracy, optimize medical treatment and outcomes, improve functional status, recommend the most appropriate living environment, and minimize unnecessary use of services. While investigators continue to refine the model of CGA, principles of geriatric care garnered from these trials have become more widely adopted in a variety of clinical settings.

Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 14 - 30
Publisher: Cambridge University Press
Print publication year: 2009

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