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The evaluation of older people varies from that of younger individuals. Geriatric patients often have multiple comorbidities that make diagnosing challenges. Moreover, their health often changes due to age, where various physical conditions and psychological patterns occur as a part of the aging process (Resnick, 2016). Therefore, geriatric assessment procedures should have their specific standards and activities to separate abnormal alterations from common occurrences. One of these approaches is the Comprehensive Geriatric Assessment (CGA) that incorporates detailed data about older patients’ unique health aspects (Rosen & Reuben, 2011). The benefit of the CGA’s attention to a selected number of factors is that it lowers adverse outcomes in older patients (Avelino-Silva et al., 2014). By using the information from the CGA, one can identify problems in geriatric patients’ health and locate issues that could otherwise be misdiagnosed with generic assignments.
Finding Differences
To differentiate between normal and abnormal changes, one should recognize that standard assessment practices may be ineffective on their own. For instance, the comparison of past medical history and present examination alone cannot reveal whether the condition is a sign of age or an unrelated illness (Rosen & Reuben, 2011). Thus, a geriatric assessment should incorporate more information that pertains to various spheres of the patient’s health – his/her social, psychological, economic, cognitive, spiritual, and other statuses. Moreover, special tools should be used to evaluate age-related changes. For example, weight loss is a characteristic of age-related frailty; however, the patient’s social and psychological assessments may reveal that this person has some underlying problems – mental illnesses (depression) or socioeconomic barriers (poverty) (Holroyd-Leduc & Reddy, 2012; Rosen & Reuben, 2011). As a result, such a multifunctional assessment can show that weight loss is influenced by the patient’s depression, a condition that should be addressed as well.
The provided example mentions only one of the frailty signs, other ones being slowness, exhaustion, impaired strength, and low energy or physical activity (Holroyd-Leduc & Reddy, 2012). The process of evaluating these factors should be followed by additional tests and discussions with the patient. Similar to weight loss being an outcome of aging or further issues, the other characteristics can also be developed as normal and abnormal responses of one’s body. For this reason, the CGA remains a valuable tool for treating geriatric patients.
CGA includes a variety of assessment checklists and activities that help review how a patient performs daily activities. For instance, functional assessment tools are focused on BADLs (“basic activities of daily living”), IADLs (“instrumental activities of daily living”), and AADLs (“advanced activities of daily living”) (Rosen & Reuben, 2011, p. 494). Answering these questions can help physicians to evaluate patients’ abilities and locate some problems that need further examination. Furthermore, social and economic assessment can reveal links between patients’ beliefs or behaviors and their health, as mentioned in the weight loss example above.
Conclusion
Overall, medical professionals need to pay significant attention to geriatric patient’s daily living activities and environment. A physical examination may reveal problems but not their causes due to older patients’ aging processes. Thus, a more comprehensive assessment such as CGA is required to distinguish normal changes from abnormal developments. The evaluation of one’s daily living activities, independence, socioeconomic status, relationships, and mental health can provide more information about the patient and describe the reasons behind his/her illnesses and behaviors.
References
Avelino-Silva, T. J., Farfel, J. M., Curiati, J. A., Amaral, J. R., Campora, F., & Jacob-Filho, W. (2014). Comprehensive geriatric assessment predicts mortality and adverse outcomes in hospitalized older adults. BMC Geriatrics, 14(129), 1-8.
Holroyd-Leduc, J., & Reddy, M. (Eds.). (2012). Evidence-based geriatric medicine: A practical clinical guide. Hoboken, NJ: Blackwell Publishing.
Resnick, B. (Ed.). (2016). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (5th ed.). New York, NY: American Geriatrics Society.
Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 78(4), 489-497.
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