17. CGA in Primary Care Settings: Weight loss and nutrition issues
Nutritional status can be easily assessed, and problems can often be addressed quickly. Key questions about diet, appetite and weight should be on the menu of any Comprehensive Geriatric Assessment.
18. CGA in Primary Care Settings: End of life care issues
End of life care refers specifically to the last few days or hours of life, when maintenance of comfort and dignity, and avoidance of pain and distress take priority. Many of the principles of care at the end of life are shared with CGA.
1. CGA in Primary Care Settings: Introduction
An introduction to CGA in primary care settings. This toolkit was developed by the British Geriatrics Society and has been endorsed by the ANCD for Older People and Integrated Person-Centred Care and by the Council of British Geriatrics Society, Scotland.
2. CGA in Primary Care Settings: The elements of the CGA process
An overview of how Comprehensive Geriatric Assessment (CGA) is done in the primary care setting, and what to consider when conducting the assessment.
3. CGA in Primary Care Settings: Physical Assessment
Examination of older patients incorporates all the typical aspects of clinical examination, although there are some general considerations and emphases that should be borne in mind, and specific examinations that may be more relevant in older people.
4. CGA in Primary Care Settings: Functional and social assessment
Functional assessment examines factors like mobility and daily living activities, and social assessment looks at social circumstances. Asking what the older person does and what environment they live in adds context to any Comprehensive Geriatric Assessment.
5. CGA in Primary Care Settings: Psychological components
Depression among the over-65s is often under-recognised, so CGA is not complete without assessing mental health. The assessment conversation also offers an opportunity to identify cognitive dysfunction which may be a sign of dementia or delirium.
7. CGA in Primary Care Settings: Creating a problem list
Creating a problem list as part of Comprehensive Geriatric Assessment can help identify all the issues to consider and will be helpful in drawing up a care plan.
6. CGA in Primary Care Settings: Medication review
Medication review is a core component of CGA. Older patients can have indications for multiple medications, some of which may be based on sound evidence, but others may do more harm than good. The evidence base for guideline based prescribing may not be so relevant to frail older people.
8. CGA in Primary Care Settings: Care and support planning
A reference guide to care and support planning within Comprehensive Geriatric Assessment for primary care and community clinicians, including the recommended components and tips for creating a care plan.
9. CGA in Primary Care Settings: Involving Social Services
CGA needs to consider the impact of social factors on the health and wellbeing of individuals and vice versa. Here we look at working with Social Services and the differences in the four nations of the UK.
10. CGA in Primary Care Settings: Patients presenting with mobility and balance issues
Improving older people’s walking and balancing improves quality of life, reduces dependence on health and social care and prevents falls. This guide looks at the importance of taking a full history, assessing gait and balance, and referral to physiotherapy.