Dr. Mansour Alzahrani

• Demonstrate medical assessment including history taking and physical examination of an elderly patient.
• Assess functional, psychological and social domains of an elderly patient.
• Incorporate the family in the care of an elderly patient.

• Review medical records
 geriatric syndromes and its risk factors
• Medication history
 Current and past
• Nutritional evaluation

• older age
• baseline cognitive impairment
• baseline functional impairment
• impaired mobility

• pressure ulcers
• incontinence
• falls
• functional decline
• delirium

• Sensory impairment
• Dentition
• Mood
• Memory
• Pain
• Visual and hearing assessments

Medication history
• Review all medication including OTC
• Drug allergies or previous adverse drug reactions
• Polypharmacy > 4 drugs (is it good or bad?)
• Ask the family members to bring all medications including supplements in 1st visit.
• Ask the patient to read label, open container and recognize his/her medications

Nutritional evaluation
• The type, quantity, and frequency of food.
• Assess for malnutrition and undernutrition
• weight loss 5% in last month or 10% in last 6 months.
• Ability to chew and swallow

• Mini-mental exam. For dementia.
• Geriatric Depression Scale for depression which include 5 questions:
1. Are you basically satisfied with your life?
2. Do you often feel bored?
3. Do you often feel helpless?
4. Do you prefer to stay home rather than going out and doing new things?
5. Do you feel pretty worthless the way you are now?
◦ More than 2 yes +ve

Social Assessment
• Patient’s living situation and social support.
• Address the potential hazards that increase risk of fall

• It reflects pt ability to carry on the physical and social tasks necessary for usual activities.
• It has three components:
●Activities of daily living (ADLs)
●Instrumental activities of daily living (IADLs)
●Advanced activities of daily living (AADLs)

• self-care activities include: bathing, dressing, toileting, transferring, maintaining continence, and feeding.
• Inability to do these activities indicate need for a caregiver.

Instrumental activities of daily living
• These include: using the telephone, shopping, doing housework, doing laundry, preparing meals, driving, taking medications, and managing money.
• Dependency is higher in this level of activities.

• occupational, recreational, and travel activities
• But the inability to do such activities could be due to health issue or personnel preference

• Assess mobility
• Hearing
• Visual
• MMS

• ONLY VALID FOR PATIENTS NOT USING AN
ASSISTIVE DEVICE
• Get up and walk 10ft, and return to chair
• Seconds
• <10
• <20
• 20-29
• >30
Rating freely mobile mostly independent variable mobility assisted mobility

Can the family play a role in elderly care?