GLOBAL GERIATRIC EVALUATION

-   Diagnostic process, dynamic and structured.

-   Detects and quantifies problems, needs and capabilities of the elder in the clinical, functional, mental and social´s areas to development of strategy for interdisciplinary intervention, treatment and long-term monitoring

-   Optimize resources and achieve greater independence

Objetives:

▪ Improve diagnostic accuracy based on a quadruple diagnosis

-        Clinical

-        Functional

-        Mental

-        Social

▪ Uncover previously undiagnosed treatable problems

▪ Establish an appropriate and rational quadruple therapy to the needs of the elderly

▪ Improve functional status and cognitive

▪ Improve the quality of life

▪ Resources to meet patient and familiy and social environment

▪ Reduce mortality

1. PHYSICAL ASSESSMENT CLINIC:

It should include:

-        classical clinical interview

-        examination of major geriatric syndromes

-        pharmacological history

-        nutritional histoy

-        physical examination

-        additional exploration

-        preparation of a list of problems

-        nursing needs

Great geriatric syndromes:

               Immobility

               Skin integrity

               Altered intelligence

               Introversion -à depression

               Instability

               Starvation à malnutrition

               Incontinence

               Iatrogenic à polypharmacy

               Fecal impaction

               Immunodeficiency

               Sensory impairment

               Poverty à Lack of resources

               Infamous à Terminally ill

HISTORY:

Factors that hinder the clinical interview:

-        communication difficulties

-        vague description of symptoms

-        multiple complaints

Also, it should include:

-        personal history

-        review of systems and symptoms

-        complete drug history

-        nutritional history: MNA à Mini Nutritional Assessment

PHYSICAL EXAMINATION

-        constants

-        Skin

-        Head and neck

-        Chest

-        Abdomen

-        Nervous system

-        Peripheral vascular system

-        Exploration musculoskeletal

Laboratory.

               Electrocardiogram

               Chest radiograph

               Mammography

2. FUNCTIONAL ASSESSMENT:

Collect information about the ability of the elderly to perform their daily activity and maintain their independence in the medium in whuch it is.

-        Basic Activities of Daily living:

o       Food

o       Dress

o       Wandering

o       WC

o       Bath

o       Arrangement

o       Transfer

o       Continence

o       Communication

-        Instrumental activities of daily living:

o       Writing

o       Reading

o       Kitchen

o       Cleaning

o       Shopping

o       Washing clothes

o       Climbing stairs

o       Use phone

o       Medication management

o       Managing money

o       Transportation

Scales à Basic activities of daily living:

Index of activities of daily living: KATZ

Barthel Index

Scale disability Red Cross

Plutchik Scale

Scales à Instrumental activities of daily living:

Lawton and Brody index

Personal reflection:

Make a rating of the patient in order to discover and help the problems the patient may have.

To do this, we will have a clinical interview, physical examination, use of scales to help the patient, and whether a patient is dependent or independent.

BIBLIOGRAPHY:

Trigas-FerrinM, Ferrira-Gonzalez L, Mejide-Minguez H. Escalas de valoración funcional en el anciano. Galicia. 2011