Assessment of the Elderly Chapter 7

Background Comprehensive Geriatric Assessment is an important method for helping social workers address the needs of older adults. Assessing the ability of an individual to complete activities of daily living can be crucial to determining the interventions and supports necessary for a client. Instrumental activities of daily living are necessary for an individual to be able to live independently within a community or individual setting. Assessment is necessary on global domains in order to provide comprehensive care and to address the actual needs of a client.

Elements of the Comprehensive Assessment Mental Status – Should be an initial component of the comprehensive assessment – The basis of all other assessments, as the current mental status of an individual can temper the responses from other assessment collection procedures. – Requires a practitioner to assess at minimum the client’s level of consciousness, orientation to times and place, and attention and memory. – Each of the domains in a mental status exam can provide important information concerning the client’s ability to provide historically accurate information, engage in conversations that require abstract thinking and consent to or reject care plans.

Elements of the Comprehensive Assessment Continued Functional Assessment – Assessment of an individuals capacity to perform personal care behaviors that are seen as essential to being able to care for themselves independently in the community. – Standardized measurements are available to aid in this assessment process. Medical History – Includes an assessment of nutritional and health behaviors. – Should include a section on the assessment of pain

Elements of the Comprehensive Assessment Continued Emotional Well-being – Includes assessing for depression and anxiety – May need to refer for psychiatric consultation if there appears to be an underlying psychiatric issue Social Assessment – The extent of the social system that surrounds the individual – The quality of that system – Includes the interaction that the client has with members of their social system – Exploration of spirituality may assist in framing this discussion as well and may also help to explain some of the clients wishes and beliefs concerning end of life issues.

Elements of the Comprehensive Assessment Continued Economic well-being – Assessment needs to determine what demands are placed on the income of the older adult in terms of expenditures and whether the client perceives the income to be sufficient to meet their needs. Environmental assessment – Does the environment allow for the client to live in place without imposing physical impediments or hazards in the home. Developing a care plan – Must clearly utilize the results from the comprehensive assessment and provide the client and their family with a clear direction for plan of care citing examples from the assessment to support the care plan.