Aging Options

Don't wait for a crisis before requesting a geriatric assessment

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Usually, when we talk about assessments, we are referring to those that help qualify individuals for long term care either at home or in an institutional setting. The result is that we often recommend assessments for individuals because they are showing signs of cognitive or physical decline.  That kind of assessment can be triggered by a crisis such as a stroke or fall that causes a loved one to end up in the hospital.  In such a case, an assessment can be rushed because the family members are trying to get care in place in a short period of time.  This can create a great deal of stress because the person being evaluated may feel like the situation is out of their control and the resulting stress can create a hostile environment.

Choosing to have an assessment done when the situation doesn’t demand one provides everyone with clearer outcomes. There’s more time to perform the tests, a better chance that everyone including the person being assessed will buy into the need for the tests, a longer time frame (and thus a more thorough assessment of needs) for performing an assessment and the ability of the assessor to make longer term care suggestions.

If you read about seniors you’ll have read about Activities of Daily Living (ADLs). This is perhaps the very best description I’ve ever read about what exactly ADLs are: “Early in life, as toddlers and youngsters, we accumulate skills, which we call activities of daily living (ADLs), such as dressing, eating and personal hygiene.  Unfortunately – and not necessarily as part of normal aging – some of us start losing those capabilities at the other end of our lives.”  That quote is from Dr. Bruce R. Troen, chief of the division of geriatrics and palliative medicine at the Department of Medicine at the University at Buffalo in a news release you can read here.  Troen goes on to say that when someone we love begins to have problems with one of those ADLs, it’s time for them to undergo a comprehensive geriatric assessment.

People often put up quite a fuss about seeing a doctor about shifts in their abilities as if by refusing to see a doctor about those shifts that they somehow put off the shifts being real. That’s a bit like deciding that the check engine light is malfunctioning and using a marker to black it out so that you don’t have to look at the light.  A comprehensive geriatric assessment on the other hand is like taking your car in for diagnostic testing.  Maybe the check engine light is on because of something minor that can be relatively inexpensive to repair but maybe it’s a heads up about something major coming down the line and getting it looked at now can ultimately save you even greater heartache.  Just as with cars, an early look at the problem may help improve a senior’s health and ultimately his or her life.  Despite claims to the contrary, ignorance is not bliss.

A geriatric assessment performed by a geriatric care physician will incorporate assessments of multiple disorders, missed diagnosis, and polypharmacy (the use of four or more regular medications) for instance. A geriatrician can coordinate a more comprehensive assessment that incorporates assessments from a team of professionals including nurse practitioners, physical therapists, dentists, dieticians, optometrists, neurologists and others.  Those options simply aren’t available if there is an immediate need for care decisions.  The result is that a non-emergency assessment can provide tools and resources for the caregiver so they have a clearer understanding of the needs of their loved one and provide a foundation for appropriate care.  But, a thorough assessment can also reduce the hospitalization rate of the elderly while also enhancing their quality of life and independence.

Here’s an article with more information about when you should request a geriatric assessment.

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