Geriatric Assessment

Several components make up a comprehensive geriatric assessment. These include looking at the client’s medical, psychological, social, and environmental well-being. In addition, with the elderly patients, the nurse should evaluate for an increased falls risk, skin integrity, and the ability to independently manage their ADLs (Cary & Lyder, 2011). Prior to the assessment, it would be helpful if the nurse could review past medical visits as well as note any chronic diseases and their management. The nurse should specifically look for cognitive deficits that could have a negative effect on their assessment. Especially important is communication. If the client speaks a different primary language, the nurse would want to have an interpreter available. If the client is hard of hearing, the nurse would need to consider other forms of communication such as writing the questions or using an interpreter if the client uses sign language. Proper preparation will help the assessment be more accurate and go more smoothly. During the assessment the nurse will systematically review all of the body systems. Some highlights that should be mentioned are the skin, the musculoskeletal system, risk for falls, and ADLS. With the skin, the nurse should pay particular attention to the sacrum and heels as these are common places for skin tears that could develop into pressure ulcers if not caught and treated. When looking at the musculoskeletal system, ROM is particularly important because it could indicate how easy it is for the client to perform activities of daily living. Another tool a nurse could use is the Katz Index of Independence. It lists six areas such as bathing, toileting, and feeding and the client is scored “Yes” or “No” for independence for each item. A score of six indicates the client is fully functional and a score of two or less shows functional impairment (Wallace & Shelkey, 2008). The nurse can then use this score to make any necessary referrals and