What is Comprehensive Geriatric Assessment (CGA) and why is it done?
About this toolkit
This toolkit was developed by the British Geriatrics Society for professionals in primary care. It has been endorsed by the Associate National Clinical Director for Older People and Integrated Person-Centred Care for NHS England and by the Council of British Geriatrics Society, Scotland
“The Next Steps on the NHS Five Year Forward View published in March 2017 noted that the NHS needs to help older people living with frailty stay healthy and independent for as long as possible. This Comprehensive Geriatric Assessment Online Toolkit from BGS is an excellent and comprehensive resource and supports this need by support primary care work with older people and their families to stay well for longer “ - Dr Dawn Moody, Associate National Clinical Director for Older People and Integrated Person-Centred Care for NHS England
'This comprehensive toolkit will be a very helpful resource for primary care teams in Scotland and across the UK. We are delighted to see increasing awareness of the importance of frailty assessment in the community' - Dr Christine McAlpine, Chair of the British Geriatrics Society's Scotland Council
What is comprehensive geriatric assessment?
Comprehensive Geriatric Assessment (CGA) is a process of care comprising a number of steps. Initially, a multidimensional holistic assessment of an older person considers health and wellbeing and leads to the formulation of a plan to address issues which are of concern to the older person (and their family and carers when relevant). Interventions are then arranged in support of the plan. Progress is reviewed and the original plan reassessed at appropriate intervals with the interventions reconsidered accordingly.
Some bodies prefer to call it a comprehensive older age assessment (COAA). It is also referred to as geriatric evaluation management and treatment (GEMT). It is a form of integrated care and is an example of a complex intervention.
Why is it done?
Evidence shows that CGA is effective in reducing mortality and improving independence (still living at home) for older people admitted to hospital as an emergency compared to those receiving usual medical care.
In community settings, the evidence shows that complex interventions in people with frailty can reduce hospital admission and can reduce admission in those recently discharged and can reduce the risk of readmission in those recently discharged.
CGA is also a vital part of the management strategy for older people suspected of having frailty in order to identify areas for improvement and support to reduce the impact of frailty.
A recent study showed that comprehensive assessment and individualised care planning can reverse the progression of frailty.