Geriatric Examination and Intervention

Intrinsic: LE weakness, poor grip strength, balance disorders, functional/cognitive impairments, visual deficit

Extrinsic: polypharmacy (at least 4 prescriptive meds)

Environmental: poor lighting, rugs/carpets, lack of safety equipment in bathroom

• Anticonvulsants (peripheral neuropathy) 
• Antipsychotics (drowsiness, movement disorders (dyskinesia))
• Benzodiazepines ("pam") (drowsiness)
• Hypnotics
• Antidepressants

• Muscle weakness 
• Gait deficits
• Assistive device
• Arthritis
• Depression
• Age > 80
• Hx of falls
• Balance deficits
• Visual deficits
• Impaired ADL
• Cognitive impairment

• Geriatric Depression Scale:
• Self-rated questionnaire 
• 0-5 = normal
• >5 = suggests depression (follow up suggested)
• >10 = almost always depression (follow up recommended)

• Patient Health Questionnaire-2:
• Depression screening

• Dynamic Gait Index:
• 8 tasks
• 0-3 scale
• Tested w/ assistive device
• <19 = increased fall risk

• Gait Velocity:
• timed gait task
• <.56 m/s = increased fall risk

• Activities-Specific Balance Confidence Scale (ABC):
• Self-report of confidence while performing 16 activities
• <67% = increased fall risk

• Life Satisfaction Questionnaire-9:
• Addresses overall life satisfaction (score 1-6)
• Less than or equal to 4 = dissatisfied

Physical abuse: neglect or mistreatment, bruises, pressure marks, broken bones, abrasions, burns

Emotional abuse: unexplained withdrawal from normal activities, sudden change in alertness, unusual depression, strained/tense relationships, frequent argument between caregiver and pt

Financial abuse: sudden changes in financial situation

Neglect: bedsores, unattended medical needs, poor hygiene, unusual weight loss

Verbal/emotional abuse: belittling, threats or use of power/control

• Hwalek Sengstock Elder Abuse Screening (HS/East): violation of personal rights, vulnerability, potential abuse
• American Medical Association (AMA) Screen for Abuse/Neglect
• Partner Violence Screen