Geriatric Syndromes

• Caregiver Stress

  Caregivers often develop coping strategies to handle the burden of providing care. However, many caregivers don’t have the necessary strategies to cope well with caregiving, which may lead to poorer mental and physical health outcomes. The American Psychological Association (APA) has more caregiver assessment tools for your review.

• Cognition and Mental Health

  Maintaining cognitive and mental health is a major factor in ensuring independence and increasing quality of life for older adults. Routine assessment for depression and cognitive health in the older adult can help identify problem areas early, which can lead to better treatment options. Click here to review an article comparing depression screening tools.

• Elder Mistreatment

  Elder mistreatment encompasses acts of abuse, neglect, and exploitation against an older adult.  A 2017 review of 52 studies in 28 countries by the World Health Organization estimated 1 in 6 people aged 60 years and older reported some form of mistreatment, including emotional, physical, sexual, or neglect.  Financial exploitation by a family member, emotional mistreatment, and neglect were the most highly reported forms of abuse in the older population in this study.  Older adults with a lower income, unemployed or retired, in poor health, with low social support are more likely to experience elder mistreatment. HealthAging.org sponsored by the American Geriatrics Society provides resources, including a tip sheet, on preventing elder abuse and neglect in older adults.

• Falls and Imblance

  Falls are common in the older population and can cause discomfort, injury, and disability.  In fact, 1 in 3 people over the age of 65 will fall every year. It’s up to health care providers to help their older patients protect against falling.  The STEADI Tool Kit for Health Care Providers through the CDC has information and several resources you may wish to review on falls protection and prevention.

• Functional Ability

  Functional assessment looks at the ability of an older person to perform activities necessary or desirable in daily life.  Assessment of an older person’s functional abilities can be a sensitive indicator of health or illness in older adults, and can determine current and future health care and psychosocial needs for older adults.  The most common assessment tools used to assess functional ability are the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living Scale. 

• Immunizations

  Instead of using an assessment tool to check the immunization status of an older adult, health care workers will need to interview the patient, refer to the patient chart, and follow the recommended adult vaccination schedules. There are multiple adult immunization schedules and guides available for consumers and healthcare workers. You might also want to review the Centers for Disease Control and Prevention (CDC) website, which has information and resources on adult immunization schedules as well as information on flu vaccines for older adults.

• Medications

  Although medications are a useful tool in treating and preventing disease in older adults, the benefits versus the risks of medication use in the older population is complicated.  Due to the physiologic changes in older adults’ bodies, it’s important to make appropriate therapeutic decisions and to avoid medication related problems. The American Geriatrics Society (AGS) Beers Criteria is an excellent resource for keeping track of potentially dangerous medications for older adults.  The American College of Preventive Medicine has additional information on interviewing patients/clients for medication adherence.

• Nutrition

  Nutrition assessments are recommended for older adults who are at risk for having inadequate nourishment or of being malnourished. Malnutrition is associated with functional decline, decreased bone mass, impaired muscle function, immune dysfunction, anemia, reduced cognitive functions, poor wound healing, higher hospital and readmission rates, more complications, and higher risks of mortality. Patients should be referred to a dietitian for further nutrition management strategies. You may wish to review this brief for more information on the assessment and management of nutrition in older adults.

• Oral Health

  People are living longer with natural teeth, which means we are likely to see more tooth decay, gum disease, dry mouth, and oral cancer as our population ages.  Poor oral health can have a negative impact on the quality of life of older adults, and can lead to a decrease in the functional, social, and psychosocial well-being of older adults.  The Division of Oral Health at the Centers for Disease Control and Prevention (CDC) provides resources and information on oral health.

• Palliative Care

  Palliative care is specialized medical care for very ill patients from a team of interdisciplinary healthcare providers.  The focus of palliative care is on relieving the symptoms, pain, and stress of any serious illness regardless of diagnosis. The National Palliative Care Research Center has a variety of palliative care assessment tools, including assessments for pain, fatigue, and palliative care.

• Pressure Ulcers

  Both risk assessments and grading tools are useful in diagnosing and monitoring pressure ulcers. Where the risk assessment is used to assess the risk of pressure ulcer development in an attempt to minimize further risk, grading tools are useful for assessing pressure ulcers over time.  The National Pressure Ulcer Advisory Panel (NPUAP) has an array of useful information and resources on pressure ulcers.

• Urinary Incontinence

  Urinary continence (UI), or the loss of bladder control, is a common problem among older adults and may be caused by everyday habits, underlying medical conditions, or physical problems. Older adults may experience falls, skin irritation, which can lead to pressure ulcers, social isolation, and depression as the result of having an UI.  Not only does UI negatively impact an older adult’s life, it is also costly to treat. Learn more about the clinical guidelines for urinary incontinence provided by the Agency for Healthcare Research and Quality (AHRQ). The National Institute on Aging (NIA) also has a resources on urinary incontinence.