PAFP-DTTB LEARNING COURSE

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GERIATRIC CARE
LEARNER’S GUIDE
PAFP-DTTB LEARNING COURSE
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GERIATRICS
• To integrate the learnings for geriatric care to
PFC analysis of a sample case

OBJECTIVES
PAFP-DTTB LEARNING COURSE
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GERIATRICS • Go through the consolidated reading material

• Answer the questions in this module using
the google form answer sheet to be found in
the link below
INSTRUCTION • For your documentation, you may place your
answer to this output form as well
• Please refer to the additional reading material
as reference to aid your answering process.

https://bit.ly/GERIA-ADDITIONAL-REFEREN
CE
 PAFP-DTTB LEARNING COURSE
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For your answer sheet, access the google form
answer sheet of your cluster from the link
GERIATRICS below:

Cluster 1 👉 https://bit.ly/CLUSTER1-ANSWERSHEET

Cluster 2 👉 https://bit.ly/CLUSTER2-ANSWERSHEET
GOOGLE FORM Cluster 3 👉 https://bit.ly/CLUSTER3-ANSWERSHEET
ANSWER SHEET LINK
Cluster 4 👉 https://bit.ly/CLUSTER4-ANSWERSHEET
Cluster 5 👉 https://bit.ly/CLUSTER5-ANSWERSHEET
 PAFP-DTTB LEARNING COURSE
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GERIATRICS

CASE VIGNETTE
 Insert the biomedical data that is known so far in the blank
space of the table

BIOMEDICAL PSYCHOLOGICAL SOCIAL

Remedios, 68 years old, female,
seamstress/vendor
Chief complaint: elevated BP
Source of reliability: son and patient
herself
HPI:
Known Hypertensive for 10 years with
maintenance medications of losartan
50 mg twice daily with BP of 150-
160/100.

Past medical history:

No previous
hospitalization/Surgeries/Trauma
Menoapaus at 55years old
 Insert the biomedical data that is known so far in the blank
space of the table

BIOMEDICAL PSYCHOLyOGICAL SOCIAL

Personal and Social History:
Non-smoker, non-alcoholic beverage
drinker
Works mainly as seamstress/vendor of
'ulam' in front of her house
She lives alone in n apartment for 3
years
Diet: Coffee, Oily foods, Meat, Pork

Mental history: sometimes forget

transactions

BIOMEDICAL
Physical examination:
General Survey: awake, conscious,
coherent, ambulatory, conversant,
oriented
vital signs: HR 72bpm, RR 15cpm T
36.5 C Wt 73kg Ht 158cm BMI 29.3
HEENT: unremarkable
Chest: Unremarkable
Abdomen: Unremarkable
Extremities: swelling of knuckles, joints
of right hand, no crepitus on palpation,
no pain, no redness, no swelling.
limitation of flexion and extension of
movement exercise due to pain
Insert the biomedical data that is known so far in the blank
space of the table
PSYCHOLOGICAL
Upon asking what is her worries /
concerns:
“Wala po dok. Masyado lang
nerbyoso itong anak ko na ‘to. Ka
lalaki pa man ding tao eh alala ng
alala. Kaya ko naman ang sarili ko.
Sa katunayan nga, nakaka palengke
ako, nakaka luto, at nakaka kain ng
maayos. Kaya nga buhay pa din ako
ngayon at nakikita nyo naman na
ang lusog ko. Sa sobrang lusog nga
ang taba ko na nga po, hindi ba dok?
ECMs to be identified:
Perception of being healthy is being
“large” physique
No realization on the potential impact Problematic relation with the
of hypertension
SOCIAL
Upon asking how is she in relation to
her community:
“Kailangan maging maayos ako
palagi, para makapag trabaho at ng
hindi maging ‘pabigat’ sa aking anak
na nag uumpisa pa lang ng kanyang
buhay. Ang mga kapit bahay naman
na yan eh wala ng nagawa kung hindi
tsismisin ako at mangakailam. Inggit
lang sila kasi na kahit namatayan ako
ng asawa, at simple lang ang trabaho
ko, eh nakapagpa tapos ako ng
engineer na may magandang trabaho
sa Maynila.”
Data extracted:
neighbors – mistrust
Proud of her accomplishemt
 DIAGNOSTICS

You will now see the laboratory tests that you supposed to have ordered.
Provide the rationale for doing these tests in relation to the biomedical condition of
Remedios.

CBC Lipid profile

Blood sugar Hand x-ray

Serum electrolytes Urinalysis

Serum creatinine
 DIAGNOSTICS

CBC RATIONALE FOR DOING THIS TEST:

To identify if there is anemia and infections

 DIAGNOSTICS

Blood sugar RATIONALE FOR DOING THIS TEST:

To screen for diabetes. All age 40 and above are recommended to

have FBS
 DIANOGSTICS

Serum electrolytes RATIONALE FOR DOING THIS TEST:

To identify for electrolyte imbalances

 DIANOGSTICS

Serum creatinine RATIONALE FOR DOING THIS TEST:

To identify function of kidney as patient is hypertensive

 DIAGNOSTICS

Lipid profile
RATIONALE FOR DOING THIS TEST:

To identify if patient has dyslipidemia as she has high BMI

 DIANOGSTICS

Hand x-ray
RATIONALE FOR DOING THIS TEST:

Patient has swelling on joints of right hand and limitation of

flexion and extension. This is to Identify if there is narrowing of
joint space between adjacent bones as it loss joint cartilage, bone
spur formation and ever fracture
 DIANOGSTICS

Urinalysis RATIONALE FOR DOING THIS TEST:

To identify if there is infection, dehydration
 Provide the score and come up with the total score as
well as the interpretation

Domain Patient’s result Score

Orientation (1) Was able to state the year, month, day, day of the week, and season 5

(2) Was able to say that she is in your clinic, located at 2 nd floor of the regional hospital 2

Registration (3) Patient was able to echo 2 names of the object after 7 trials 2

Attention and calculation (4) Was able to spell the word “KARNE” backwards as “ENRK” 4

Recall (5) Was only able to re-echo 1 of the 2 objects taught in registration 1

Language (6) Was able to name pencil and watch 2

(7) Was not able to repeat the phrase “Minikaniko ni Monika ang Makina” 0

(8) Upon given the instruction saying: to pick up the paper with non-dominant hand, fold it to half, 1
and place on lap, patient picked up the paper with her dominant hand, did not fold and placed on
her lap
(9) Upon reading “ipikit ang mga mata,” patient was able to close her eyes 1

(10) Patient was not able to write a sentence that contains noun and a verb. 0

(11) Was not able to copy the pentagon shape. 0

TOTAL SCORE (12) 18

Interpretation (13) –
 List down the clinical salient features

CLINICAL SALIENT FEATURES

 List down the salient features in relation to
complete geriatric assessment

CGA SALIENT FEATURES

 PAFP-DTTB LEARNING COURSE
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GERIATRICS

PATIENT-CENTERED
CARE
DIAGNOSIS RATIONALE
Hypertension-stage II- uncontrolled

Osteoarthritis

Moderate Cognitive Impairment

 PSYCHOSOCIAL WORKING IMPRESSION /
PLAN

With all the data at hand, admixed with knowledge gained from the previous
modules, give your psychosocial management plan that is fit for this patient’s
condition and status.
DOMAIN PERTINENT FINDINGS SUGGESTED INTERVENTION
PSYCHOLOGICAL
SOCIAL
PATIENT-CENTERED
WELLNESS PLAN
Remedios’ wellness plan
Risk assessment Underlying factor(s) Recommended Screening test Advise/ counselling
that leads to immunization/ needs
development of risk chemoprophylaxis
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GERIATRICS

FAMILY-FOCUSED
CARE
GENOGRAM
APGAR
APGAR - NARRATIVE
 FAMILY-FOCUSED CARE
ANALYSIS OF DATA PART 1

Come up with your won analysis of the data obtained from the applied family
assessment tools and provide your answer to the table.
FAMILY ASSESSMENT TOOLS FINDINGS
Family structure
Family life cycle stage
APGAR
 FAMILY-FOCUSED CARE
ANALYSIS OF DATA PART II

Now that you have analyzed the current situation of the family, integrate these
knowledge in to your care plan for the improvement of care to be given to
Remedios, buy completing the table.
INTEGRATION OF FAMILY FOCUSED ANALYSIS TO IMPROVEMENT OF CARE PLAN
Problem How can family contribute for Is the idea on previous column Give your rationale for the If the answer for the second
improved care delivery for achievable? (answer either as answer on second column column is difficult, could there
ACHIEVABLE / DIFFICULT)
the problem be alternative intervention we
can think of?
PAFP-DTTB LEARNING COURSE
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GERIATRICS

COMMUNITY-
ORIENTED CARE
ECOMAP
SCREEM
 COMMUNITY-ORIENTED CARE
ANALYSIS / SYNTHESIS

Come up with your won analysis of the data obtained from the applied tools and
provide your answer to the table.
COMMUNITY ORIENTED DATA ANALYSIS
Enabler(s) noted in the community
to achieve wellbeing
Barrier(s) noted in the community to
achieve wellbeing
DILEMMA NOTED IN PATIENT-
CENTERED AND FAMILY-FOCUSED
ASSESSMENT THAT WE MAY FIND
SOLUTION IN COMMUNITY
SUGGESTED COMMUNITY
ORIENTED INTERVENTION
 COMMUNITY-ORIENTED CARE
ADDITIONAL PROGRAM THAT MAY HELP THE
PATIENT

List down the currently available programs for the elderly that is being offered in
your respective area of practice, regardless of the program originating from
central or local agencies.
Lists of currently available programs programs available in your respective area of practice that will aid in improving
Remedios' health status? (ex: free medicine program for hypertension, senior discount programs, etc.)
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GERIATRICS

GRAND SYNTHESIS OF
DATA AND PLAN
 GRAND SYNTHESIS AND PLAN

Now let us summarize the plans raise for patient-centered, family-focused, and
community-oriented care plan mentioned in the previous slide, to complete the
PFC table of care plan for Remedios.
PFC MATRIX OF CARE PLAN FOR REMEDIOS
PATIENT-CENTERED FAMILY FOCUSED COMMUNITY ORIENTED
Biomedical Family profile Community
problem list profile
(Enablers of
the care /
Barriers to
the care)
Psychosocia Complicating Community
l problem family resources
issues / available to
findings for be
the treatment integrated in
of the patient the
improvement
Suggested Suggested
of care plan
managemen intervention
t for the issues
identified
 PAFP-DTTB LEARNING COURSE
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GERIATRIC CARE
END OF MODULE