Comprehensive Geriatric Assessment

Comprehensive Geriatric Assessment
Domain Dimensions of AssessmentScreening tools
Functional HealthFunctional health assessment involves the use of screening tools to assess the extent of functional decline associated with aging (Kennedy-Malone, Martin-Plank, & Duffy, 2019).  Functional assessment of geriatric patients includes evaluating the ability to perform basic ADLS such as bathing, dressing, toileting, transferring, and continence (Kennedy-Malone et al., 2019).  The functional assessment also includes determining the individual’s capacity to participate in instrumental activities of daily living (IADLS) such as food preparation, household chores, managing medications, shopping, and transportation needs.  A review and assessment of the functional capacity to complete IADLS provides an appraisal of the interaction the individual has in both the community and in the home (Kennedy-Malone et al., 2019). Identifying those at risk for falls as well as fall prevention strategies are also components of a functional health assessment.  Screening tools to assess mobility, gait, and weakness are utilized to determine fall risk and appropriate interventions for prevention of falls.Katz Index of Independence In Activities of Daily Living This screening tool is used to assess functional status as a measurement of the patient’s ability to perform ADLS autonomously (Mlinac & Feng, 2016).  This tool is used to detect problems with basic daily activities; although, it is not sensitive enough to always determine early cognitive decline since basic functional skills are often preserved even if there is an impairment in cognitive function (Mlinac & Feng, 2016).   The Katz Index ranks competence in performing six functions; bathing, dressing, toileting, transferring, continence, and feeding.  A score of yes or no is given for independence in each of the six tasks.  The scores are ranked from a 6 to 2 or less, with 6 indicating full function in performing ADLS and 2 or less indicating substantial functional impairment (Mlinac & Feng, 2016). 
References Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. G. (2019). Comprehensive Geriatric Assessment. In Advanced practice nursing in the care of older adults (2nd ed., pp. 26-33). Philadelphia, PA: F. A. Davis Company. Mlinac, M. E., & Feng, M. C. (2016). Assessment of activities of daily living, self-care, and independence. Archives of Clinical Neuropsychology31(6), 506-516. doi:10.1093/arclin/acw049