When to Push For a Geriatric Assessment

Taking a team approach can net the best results for your parents. Navigating the maze of eldercare options can be challenging, but it doesn’t need to be. A geriatric assessment can help you figure out the level of care your loved one needs.

“The phrase geriatric assessment is a bit confusing,” says Norbert “Bert” Rahl, director of mental health services at the Benjamin Rose Institute on Aging. Sometimes an assessment looks at just one issue that’s causing problems for a loved one. For instance:

• If you are concerned about your loved one’s physical status, the medications they are taking or how they are (or aren’t) managing a chronic condition, a physical assessment may be in order.
• If your loved one has mobility issues and you’re worried about how well they are (or aren’t) getting around on their own, they may need a functional assessment.
• If you are worried about the psychological and emotional well-being of your loved one, a mental health assessment could be helpful.
• If your aging relative is displaying issues with memory, decision making and financial management skills, a cognitive assessment should be scheduled.

To get the full scope of what’s going on, Rahl suggests a comprehensive geriatric assessment. This assessment will look at all aspects of your loved one’s physical and mental health and how they are interacting and overlapping in their life.

A comprehensive assessment can be coordinated by your loved one’s primary care physician, but since these assessments require the skills and expertise of a team of specialists, they are best coordinated by a geriatrician. A geriatrician is a specialized physician who is trained in the care and treatment of older adults. Ask for a referral from your loved one’s primary care physician or find a geriatrician in your area.

Who Do You Need On Your Geriatric Team?

The composition of the geriatric team will vary depending on your individual’s:

• Needs
• Location
• Budget
• Health insurance

In addition to the physician who is doing the physical exam and coordinating the assessment, the team might include the following professionals:

• Geriatric manager
• Nurse practitioner
• Physical therapist
• Psychologist or psychiatrist
• Neurologist
• Occupational therapist
• Speech therapist
• Dietitian
• Audiologist
• Optometrist
• Dentist
• Podiatrist
• Artificial limb specialist (i.e. orthotist or prosthetist)
• Social worker
• Spiritual care advisor

“The setting for an assessment depends on what triggers the decision to get one in the first place,” notes Rahl.

Avoid Crisis Management

When the trigger to get a geriatric assessment is a crisis, for instance a fall, stroke or car crash, the assessment is usually done in the hospital.

“In a crisis situation, the patient is often disoriented, exhausted and in pain,” says Rahl. “The assessment might be rushed and not as thorough as it could be. Making things worse, the patient may be in denial that they even need an assessment.”

The better alternative is to schedule an in-office assessment when you and your loved one decide it’s needed because of physical or behavioral changes.

The Many Benefits to an Office-Based Assessment

For one, an office-based assessment is not done in a crisis situation, so the lab work, physical exam, mobility tests, mental and cognitive screens and other evaluations can be spread out over days or even weeks. Your loved one has chosen to get a geriatric assessment, and has not had the decision made for him or her, so they will be more cooperative. The assessment may also evaluate your needs as a caregiver.

Secondly, because the office-based assessment is done proactively, rather than reactively, it will provide results, insights, options and suggestions that can be used to plan for future needs and care.

Dealing with the growing list of caregiving concerns can be overwhelming. Visit our blog for more tips for caregivers.

Copyright© 2014 Next Avenue, a division of Twin Cities Public Television, Inc.