Comprehensive Geriatric Assessment Summary
Trait Notes
Functional ADLs (self-care): eating, dressing,
Status transferring btwn bed and chair,
toilet, controlling bowel and bladder
function
iADLs (independent living):
housework, preparing meals, taking
medications, finances, telephone
Nutrition Inadequate intake common. Esp Vit
ACDB + trace minerals (Ca, Fe, Zn)
Vision Most common causes of dec VA are
presbyopia, ARMD, cataracts,
diabetic retinopathy and glaucoma
Hearing Presbycusis 3rd most common
chronic condition in older
Americans!
Dysphagia and 50% prevalence of dysphagia. Most
Aspiration common causes are neurological
(CVA, PD, dementia)
Esp worried about aspirations; most
common cause of death in pts with
dysphagia a/w neurological
condition.
Silent aspirations however are
common in >50% of affected pts.
Infection
Assessment
Katx Index of Independence.
There’re 5 aspects and they’re each rated either
independent or dependent in each.
- Bathing
- Dressing
- Toileting
- Faecal and urinary continence
- Feeding
>6 = highly independent. 0 = very dependent
Nutritional Hx with checklist
- Illness/condition that ∆ kind/amount of
food I eat (2)
- <2 meals/d (3)
- I eat few fruits, veg, milk products (2)
- ≥3 beer, liquor or wine almost everyday
(2)
- I don’t always have enough $ for food I
need (4)
- I eat alone most of the time
- ≥3 prescription/OTC drugs a day (1)
- W/o wanting to, I have lost/gained 5kg in
past 6/12 (2)
- I’m not always physically able to shop,
cook or feed myself (2)
Record of usual food intake on 24hr dietary recall
Examination looking for signs of inadequate/XS
nutrition
Select Ixs
Snellen Chart on request is a good screening tool
± r/v by ophthalmologist
Whispered voice test for screening
Can send to audiologist for r/v
Hx: coughing, choking, food sticking in throat,
nasal/oral regurg
Speech path: swallow assessment
ENT: endoscopy
GIT: G-scope, barium swallow, manometry
23vPPV and flu vax are a must
Control
Pain 75% of aged care residents have Pain can be expressed in behaviour: aggression,
chronic pain. resistance, withdrawal, restlessness, expressions

Or physiology: inc HR, pulse, temp, RR, BP,

diaphoresis etc

Pain Mx is complex. Start with

Pressure Ulcers Local damage from skin
damage/shear or friction forces.
Friction and moisture are the
strongest factors in superficial skin
breakdown
nonpharmacological, pharmacological (as per
analgesic ladder) and adjuvants.
Daily inspection: examine over bony
prominences (heels, malleoli, sacrum).
Protect skin: from moisture (incontinence), harsh
cleaners)
Optimise nutrition and hydration
Cellulitis or bacteraemic

Norton Scale: score <14 pt is at risk

Falls and Hip Falls are a strong marker of inc Medication R/v. Cognitive and sensory
Prevention frailty assessment.
BMD, footwear, CV assessment, infectious
screen.
Check for environmental RFs
Faecal 50% of aged care residents. Has Assess what the cause is and treat appropriately.
Incontinence psychological and biological
consequences.
Urinary 75% of aged care residents. NOT A Evaluate cause. Then also look at fluid intake,
Incontinence NORMAL PART OF AGEING. meds, cognitive fx, mobility and previous
urological Hx.

U/A, MCS, bladder chart and USS of bladder.

Depression GDS

Delirium
Dementia MMSE, clock drawing test