The topic content is divided into the information types below
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.
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.
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.
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.
12. CGA in primary care settings: Patients at risk of falls and fractures
Often a key component of Comprehensive Geriatric Assessment in primary care, this guide examines step-by-step how to carry out a multifactorial risk assessment for falls.
13. CGA in primary care settings: patients presenting with depression
Dealing with the management of depression as part of Comprehensive Geriatric Assessment including the treatments to consider.
14. CGA in primary care settings: patients presenting with confusion and delirium
The prevalence of delirium in the community is 1-2 per cent but this rises to 14 per cent in people over 85, and in nursing homes or post acute care settings, can be up to 60 per cent. This guide deals with risk factors, diagnosis and management of this condition.
15. CGA in primary care settings: mental capacity issues
Assessment of mental capacity should be a routine part of Comprehensive Geriatric Assessment. This guide lays out the principles which govern testing mental capacity, advance care decisions and powers of attorney, along with the safeguards.
16. CGA in primary care settings: patients presenting with urinary incontinence
Bladder control problems are a common problem in older people and result from a variety of causes. Continence issues are an essential part of any Comprehensive Geriatric Assessment, and this guide examines the causes, assessment, management and treatments available.
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.
Depression among older people living in care homes report
A joint report by the BGS and RCPsychs which collates and showcases examples of the best practice which flow from effective interdisciplinary collaboration and practice in treating depression in older people living in care homes.
NICE: Intermediate care including reablement
NICE standard covers referral and assessment for intermediate care. It covers bed-based intermediate care, crisis response, home-based intermediate care and reablement. It describes high-quality care in priority areas for improvement.
Tools for Clinical History-Taking
A list of validated tools which may be useful in augmenting clinical history-taking as part of comprehensive geriatric assessment, or as screening tools to trigger the need for an in-depth assessment.
Continence Care in Residential and Nursing Homes
Many of the residents are likely to have some degree of urinary incontinence or dysfunction. Urinary incontinence in this setting should not be viewed as inevitable. With good management it may be preventable. Incontinence is a symptom of underlying problems.