Geriatric Assessment

What is a geriatric assessment?

A geriatric assessment (GA) is a long visit, or a series of visits, to check all aspects of an older person’s condition. The assessment may be done by a geriatrics doctor or at a clinic with doctors, nurses, psychologists, and other health professionals. The assessment covers not only medical conditions but also the ability to live at home, ability to think and make decisions, a person's mood, and support systems. It is usually done when an older person's health or mental or physical abilities change.

The exam can help figure out what may be causing problems and what can be done. For example, it can help determine what kind of help is needed, who will provide care, and where the older person might live. Addressing these concerns can allow an older person to stay independent and have a better quality of life for a longer time.

What is done during the assessment?

A doctor and other healthcare professionals (usually a nurse or social worker) will evaluate the person's:

• physical health
• mental health
• social situation
• ability to perform activities of daily living (ADLs)
• financial situation.

They will look for current problems and see what might be done to prevent more problems. The assessment should include:

• medical history
• physical exam
• a functional status review, looking for things the person can do well and for disability problems
• review of all medicines, supplements, and natural remedies
• a review of the person’s diet and dietary needs
• lab tests
• X-rays, if needed
• review of social supports, that is, who helps with daily activities, who provides emotional or spiritual support, and who the emergency contacts are

Tests of the following can show how well the older adult functions:

• vision
• hearing
• shoulder and arm function
• leg and hip function
• bowel and bladder control
• diet
• the ability to think, remember, and reason
• walking and balance
• strength
• sleep habits.

The person’s ability to manage activities of daily living (ADLs) will be assessed. ADLs include:

• bathing and brushing teeth
• dressing
• controlling bladder and bowels and using the bathroom
• getting in and out of bed, walking, or using a wheelchair
• feeding oneself
• using the telephone
• shopping
• cooking
• cleaning
• doing laundry
• taking medicines without help
• handling money.

The exam should check for mental health problems, such as depression or anxiety. It should also include questions about the use of tobacco, alcohol, and other substances.

Financial resources and the need for services in the home are also assessed.

The older adult’s wishes about care in an emergency may also be noted. Often this discussion is kept separate from other assessment activities.

If safety issues in the older adult’s home are a concern, someone may:

• Ask the older adult to show that they can cook safely.
• Ask the older adult who they would call in an emergency.
• Make sure the neighborhood is safe.
• Check for door locks, window locks, and fire extinguishers and make sure the older adult is able to use them.
• Check for safe lighting, stairs, handrails, and nonskid floors and walkways.
• Check the location of bedrooms, bathroom, telephones, and the laundry area.
• Look in cupboards and the refrigerator for the amounts and quality of food.

The assessment gives everyone a picture of what the older adult can still do safely. It also helps you know where help is needed. After an assessment is complete, the healthcare provider, caregivers, and older adult can develop a complete plan of care. All parties can keep track of the issues raised in the assessment. They can also track the priorities and actions in the plan of care.