GERONTOLOGY MODULE 1

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A. Routine history for an elderly should be taken from the patient themselves as well as
their family members or caretaker.History should be taken based on geriartric assessment
like : mobility and falls,cognition,activities of daily living,mood and behaviour,bladder and
bowel, ,vision and hearing,nutrition and sexual function.It includes:
-Past medical history:any history of hospitalisation
-Medical history:ask if any presenting complaints.Also explore more regarding patient
perspective and expectation towards illness.
-Surgical history:ask any surgery done before and any complications towards that.
-Drug history: All drugs intake should be recorded,dietary supplements,any traditional
medications intake.Family members to bring all the medications during visits in clinic.
-Menstrual status: menopause status and in what age.
-Smoking and alcohol history:if still taking should be counselled to stop.
-History of family,social,socioeconomic,environmental,home condition and safety.Will ask
regarding living arrangements,with whom they live and where,accessibility in their
residence. Also asked about her daily activities everyday at home.
-Dietary history: should explore more about type,quantity and frequency of food taken.The
ability to eat,to evaluate swallow and chew.
-Any impairments: hearing or visual.
-Psychiatric assessment and mental state like emotion or any mental symptoms.Patient
should be asked if any delusions,hallucinations.past mental health care,ay use of
psychoactive drugs and any recent changes.
-Functional status:is patient able to function independently in her daily activities(ADL) or
instrumental ADL or need total assistance.
-Sleep assessment:to ask her sleep patterns,whether she can sleep properly or any sign of
insomnia.
Hence,all assessment can be obtained during several visits tomaximize history in all aspects.

B. Advise and health promotion i can give to her is regarding maintaining and increasing
functional capacity,maintainingand improving self care.I will advise for physical
activities,smoking status and any alcohol intake for reduction,good lifestyle,and
participating in the community. Chemoprevantion and immunization for elderly includes;
-Influenza vaccination is recommended for yearly basis.
-Used of aspirin to prevent artherosclerotic cardiovascular disease if any risk of stroke.
-Pneumococcal vaccination as to prevent pneumococcal infection.
Another aspect is lifestyle maintainence to prevent chronic disease:
-Diet control:reduction of saturated fats,sodium and sugar intake.Increase of taking fruits
and vegetables.
-Physical activities:exercise such as muscle strengthening,stretching with mderae activities
help to prevent osteoarthritis.
Few screening recommendations for elderly patients such as:
-Cognitiveimpairments screening ad mental screening help to prevent mental healt disorder.
-Yearly bedside hearing test is recommended.
-Blood pressure monitoring and plasma glucose monitoring regularly to detect any
abnormality.
-Yearly risk of fall assessment and prevention is very important for elderly.
-BMI should be assessed among elderly.It also to assess their nutrition level.
-Regular pap smear yearly for early detection of cervical cancer.
-Mammogram is recommended for women yearly for age 50 years old with or without any
symptoms.
-Colorectal screening yearly is recommended.
-Hepatitis B and C screening.
-Latent TB screening is also important even asymptomatic as elderly is in high risk group.
Apart from that,patient also should be screened for :
-Urinary incontinence
-Hearing impairment
-Visual impairment:eye assessment,funduscopy.

REFERENCES:
1. Cigolle CT, Langa KM, Kabeto MU, et al. Geriatric conditions and disability: the Health
and Retirement Study. Ann Intern Med 2007; 147:156.

2. Stuck AE, Siu AL, Wieland GD, et al. Comprehensive geriatric assessment: a meta-
analysis of controlled trials. Lancet 1993; 342:1032.

3. Devons CA. Comprehensive geriatric assessment: making the most of the aging
years. Curr Opin Clin Nutr Metab Care 2002; 5:19.

4. Elsawy B, Higgins KE. The geriatric assessment. Am Fam Physician 2011; 83:48.

5. Cereda E, Pedrolli C, Klersy C, et al. Nutritional status in older persons according to

healthcare setting: A systematic review and meta-analysis of prevalence data using MNA®.
Clin Nutr 2016; 35:1282.

6. BASSEM ELSAWY, MD, and KIM E. HIGGINS, DO, Methodist Charlton Medical Center,
Dallas, Texas. The Geriatric Assessment. American Family Physician. 2011 Jan 1;83(1):48-56.
7. Murtagh, J., & Rosenblatt, J. (2015). Murtagh's General Practice (6th ed.). Australia:
Mc-Graw Hill.