Geriatric assessment measure | Geriatric assessment: Guided interventions |
Function and falls - Instrumental activities of daily living deficit
- History of falls
| - Physical therapy and/or occupational therapy referrals to prescribe strength and balance training, assist device evaluation, home exercise program, and safety evaluation
- Fall prevention discussion
- Home safety evaluation
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Comorbidity domain - Comorbidity and polypharmacy considerations
| - Involve caregiver in discussions to assess risks of therapy and management of comorbidities
- Involve primary care physician and/or geriatrician in decision making for treatment and management of comorbidities; consider referral to geriatrician
- Review medication list and minimize medications as much as possible; consider involving a pharmacist
- Assess adherence to medications; have patient bring in medications to review
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Cognition - Screen positive on validated cognitive screen
| - Assess decision-making capacity and ability to consent for treatment
- Identification of health care proxy and involve proxy in decision making for treatment, including signing consent forms with patient
- Delirium risk counseling for patient and family
- Medication review to minimize medications with higher risk of delirium
- Consider further workup with geriatrician or cognitive specialist
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Depression - Geriatric Depression Scale >5
| - Consider referral for psychotherapy/psychiatry
- Consider cognitive-behavioral therapy
- Social work involvement
- Consider pharmacologic therapy
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Nutrition | - Nutrition counseling
- Referral to nutritionist/dietician
- Assess need for extra support for meal preparation and institute support interventions if necessary (eg, caregiver, Meals on Wheels)
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