Geriatric assessment

COMPREHENSIVE GERIATRIC ASSESSMENT

1. GERIATRIC ASSESSMENT NITHIN NAIR (MPT-1)

2. INTRODUCTION COMPREHENSIVE GERIATRIC ASSESSMENT MULTIDIMENSIONAL PROCESS AIMS TO RECOGNISE COMMON GERIATRIC DISORDER TO PLAN EFFECTIVE TREATMENT PROGRAM TO IMPROVE OVERALL HEALTH AND FUNCTIONAL OUTCOMES TO REDUCE VULNERABILITY TO SUBSEQUENT ILLNESS TO IMPROVE QUALITY OF LIFE

3. SUBJECTIVE EXAMINATION DEMOGRAPHIC DATA CHIEF COMPLAINTS HOPI CLIENTS HISTORY OF PAIN / SYMPTOMS SYSTEMIC REVIEW: MSK, NEURO, CARDIO – RESPI, SPECIAL SENSES, BOWEL AND BLADDER HISTORY OF FALL : YES / NO PAST MEDICAL / SURGICAL HISTORY PERSONAL HISTORY INVESTIGATION DRUG HISTORY ENVIRONMENTAL HISTORY: INTERIOR AND EXTERIOR PSYCHOSOCIAL HISTORY: COGNITION, MEMORY, DEPRESSION FUNCTIONAL HISTORY: INDEPENDENT, WITH OR WITHOUT WALKING AIDS SOCIO ECONOMIC STATUS : KUPPUSWAMI / PRASAD / STANDARD OF LIVING INDEX

4. HYPOSTHESIS FORMATION SOURCE OF SYMPTOMS STRUCTURES INVOLVED CONTRIBUTING FACTORS PHYSICAL BIOMECHANICAL BEHAVIOURAL EMOTIONAL ENVIRONMENTAL DIFFERENTIAL DIAGNOSIS

5. OBJECTIVE EXAMINATION ON OBSERVATION General Condition Built Nutrition Skin / Nail Condition Attitude of limb Pallor/ Icterus/ Cyanosis/ Clubbing/ Oedema Shape of Chest Type of Breathing Chest Movements I:E Posture Gait Wound Deformity Assistive Devices (If Any)

6. OBJECTIVE EXAMINATION

7. PHYSICAL ASSESSMENT MUSCULOSKELETAL EXAMINATION RANGE OF MOTION – AROM, PROM, ENDFEEL, JOINT REACTIVITY, JOINT IRRITABILITY JOINT PLAY CAPSULAR PATTERN MUSCLE STRENGTH MUSCLE TIGHTNESS SPECIAL TEST FUNCTIONAL DIAGNOSIS

8. PHYSICAL ASSESSMENT NEUROLOGICAL EXAMINATION MOTOR ASSESSMENT SENSORY ASSESSMENT REFLEX TONE ASSESSMENT BALANCE & CO-ORDINATION CARDIO-RESPIRATORY EXAMINATION CHEST AUSCULTATION CHEST EXPANSION CHEST EXCURSION

9. PHYSICAL ASSESSMENT SPECIAL SENSES EXAMINATION VISION : ACUITY, PERIPHERAL VISION, CONTRAST AND SENSITIVITY, DEPTH PERCEPTION HEARING : WHISPER TEST VESTIBULAR SYSTEM : VOR (SMOOTH PURSUIT, SACCADIC)

10. PSYCHO-SOCIAL ASSESSMENT MMSE / MOCA GDS

11. ENVIRONMENTAL EXAMINATION FUNCTIONAL HOME ASSESSMENT PROFILE HOME SAFETY ASSESSMENT CHECKLIST

12. FUNCTIONAL ASSESSMENT TUG BBS / MINI BESTEST FES BARTHEL INDEX POMA 6MWT

13. FALL ASSESSMENT

14. POSTURAL CONTROL THEORY ACQUIRE INFORMATION - SENSORY DETERMINE RESPONSE IN ADVANCE – CENTRAL PROCESSING CARRY OUT RESPONSE – EFFECTOR

15. FALLS ASSESSMENT

16. FALLS HISTORY NUMBER OF FALLS ONSET ENVIRONMENTAL FACTORS ACTIVITIES AT THE TIME OF FALL PRESENCE OF DIZZINESS, VERTIGO CURRENT AND PAST MEDICATIONS DIRECTION OF FALLS

17. ETIOLOGICAL ASSESSMENT SENSORY – VISION (ACUITY, DEPTH PERCEPTION, PERIPHERAL VISION, CONTRAST & SENSITIVITY), SOMATOSENSORY (JOINT PROPRIOCEPTION, VIBRATION), VESTIBULAR (VOR) EFFECTOR – STRENGTH, ROM, FLEXIBILITY, ENDURANCE CENTRAL PROCESSING – FEEDBACK (MOTOR STRATEGIES), FEEDFORWARD, REACTION TIME

18. FUNCTIONAL ASSESSMENT TUG BBS / MINI BESTEST FES BARTHEL INDEX POMA 6MWT

19. ENVIRONMENTAL EXAMINATION FUNCTIONAL HOME ASSESSMENT PROFILE HOME SAFETY ASSESSMENT CHECKLIST

20. PSYCHO-SOCIAL ASSESSMENT MMSE / MOCA GDS

21. References GERIATRIC PHYSICAL THERAPY – ANDREW GUCCIONE (2 ND AND 3 RD EDITION)