The topic content is divided into the information types below
Hospital-Wide Comprehensive Geriatric Assessment
A Nuffield Trust led collaboration is part of an NIHR-funded project to research acute hospital care for frail older people. The aim of the work is to inform NHS managers, clinicians, patients and the public about how best to organise hospital services for frail older people.
CGA issues: mobility and balance
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.
CGA issues: 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.
CGA issues: end of life care
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.
CGA issues: falls
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.
CGA issues: 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.
CGA issues: depression
Dealing with the management of depression as part of Comprehensive Geriatric Assessment including the treatments to consider.
Involving Social Services in CGA
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.
Psychological components of CGA
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.
The BGS toolkit for comprehensive geriatric assessment in primary care settings
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.
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.
Medication review in CGA
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.
Care and support planning in CGA
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.
Functional and social assessment in CGA
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.
CGA issues: bone health
Older people with frailty, those with reduced mobility and those with multiple co-morbidities are all susceptible to problems with bone health.
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.
Simulated practice to improve care
This Practice Question has been published with the kind permission of the Royal College of Nursing.
Could simulated practice with registered nurses improve the delivery of healthcare for older people in hospital?
Peri-operative Care for Older Patients Undergoing Surgery
The rate of older people undergoing surgical procedures is increasing faster than the rate of population ageing . Despite this progress, older surgical patients remain at increased risk.
Occupational Therapy: putting prevention at the heart of care
In its report Living Not Existing: Putting Prevention at the Heart of Care for Older People, the Royal College of Occupational Therapists seeks to show how doing the right thing for individuals can actually reduce their need for expensive care long-term.