geriatrics
Comprehensive Geriatric Assessment
Assessment Domains
The principal domains assessed are Functional ability:Ability to do activities of daily living (ADLs) and instrumental ADLs (IADLs) are assessed. ADLs include eating, dressing, bathing, transferring between the bed and a chair, using the toilet, and controlling bladder and bowel. IADLs enable people to live independently and include preparing meals, doing housework, taking drugs, going on errands, managing finances, and using a telephone. Physical health:History and physical examination should include problems common among older people (eg, problems with vision, hearing, continence, gait, and balance). Several validated screening tests for cognitive dysfunction (eg, Examination of Mental Status ) and for depression (eg, Socioenvironmental situation:The patient’s social interaction network, available social support resources, special needs, and the safety and convenience of the patient’s environment are determined, often by a nurse or social worker. Such factors influence the treatment approach used. A checklist can be used to assess home safety. Standardized instruments make evaluation of these domains more reliable and efficient (see table A Geriatric Assessment Instrument ). They also facilitate communication of clinical information among health care practitioners and monitoring of changes in the patient’s condition over time. 