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Geriatric Assessment: Junaidi - Ar
Geriatric Assessment: Junaidi - Ar
junaidi . ar
Dept. of Internal Medicine
Objectives
Goal:
Optimize function
Multiple disciplines involved – physician,
nursing, rehabilitation medicine, social work
Geriatric Medicine
Life expectancy:
75 years at birth
82 years at 65
Demography
Oxidative stress
Genetically regulated aging
Oxidative Stress
Treatment of Disease
Treatment of one illness may unmask
previously undiagnosed pathologic
condition
Urinary outlet obstruction may become
apparent when pharmacologic agent with
anticholinergic properties is given and
provokes urinary retention
Treatment of Disease
Signs and symptoms may appear
straightforward, further evaluation to
uncover an occult contributing disease is
appropriate
Certain nonspecific syndromes require more
thorough investigation
Failure to thrive
Acute change in appetite
Decline in self-care capacity
Onset of falls
Change in intellectual function
New onset of incontinence
Hazards of Bed Rest
Prevention
Passive range of motion exercises
Assumption of upright posture several
minutes/day
Frequent changes of position
Routine orders for hospitalized patients
to be out of bed for meals and daily
ambulation
Comprehensive Geriatric
Assessment
Improves function
Repetition of functional assessment may
be used to gauge impact of therapy
More appropriate medication use
May decrease number of acute care days
Functional Status
1. Cognitive Disorders
Dementia/Delirium
2. Polypharmacy
3. Falls/Gait Instability
4. Urinary Incontinence
5. Depression
6. Malnutrition
Components of CGA
Unsteadiness
Abnormality sitting or getting up from a
chair
Turning or walking with difficulty
Step height
Balance Measures
Sitting balance (leaning vs steady)
Ability to rise from chair
Immediate standing balance
Standing balance (wide based, narrow
based or assisted)
Sternal nudge
Standing balance w/ eyes closed
Visual impairment
13%
Hearing impairment
65-74y/o 25%
>85y/o 50%
Visual Impairment
Shopping
Using the telephone
Handling finances
Housekeeping
Using transportation
Food preparation
Taking medication
Assessment of Home Safety
Comprehensive Geriatric
Assessment has been advanced as
a means to more effectively
diagnose and manage complex
medical problems of frail elderly
Asesmen geriatri
Socioeconomy status
Health status
Physical,sosial,mental healhty Environment
Disease status
Fungtional status
Physiological measuress
Sign and sympioms Daily activities
Prognosis Achievement
Disabilities
Kapasitas fungsional : ADL
medical
Cognitive Affective
economic spirituality
Dalam Pelaksanaan
Panduan evaluasi
/form
Interpretasi /
keterbatasan
Membantu diagnosa
Asesmen fungsional
Dimensia
Depresi
10 ‘- 15% R jalan
20% r inap
GDS geriatric depression scale
Asesmen sosial
Agama !
Kesimpulan