The Comprehensive Geriatric Assessment

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The Comprehensive Geriatric Assessment

Introduction

Elderly patients in general, and individuals aged 70 years and older in particular, face a distinctive set of risks associated with age-related changes. The issues within physiological and physical health, economic status, social and environmental well-being, and functioning are characterized by particularities that are different for the elderly in comparison to other generations of patients. In the nursing practice, the awareness about such particularities supported by evidence contributes to the quality and relevance of care for the elderly. Indeed, the knowledge of the functional factors (common health, social, economic, emotional, and environmental experiences) allows health care professionals to develop new and adjust existing methods of care that would meet patients specific needs. In this regard, the use of the comprehensive geriatric assessment serves as a method for collecting general data on the most common experiences of the elderly aged 70 years and older. This paper is designed to conduct such assessment to collect information about the elderly as per their experiences depending on the variety of factors and address care priorities within diversity-based intersectional care.

Background Information

Historical Background

To assess the historical background that has contributed to the life experiences of people who are now aged 70 years, one should refer to the social norms and events that happened throughout their life. In particular, the assessed population constitutes men and women born in the late 1940s and early 1950s, implying that they were adults in the 1960s and 1970s. Historical events of the 1950s with the post-war economy and further changes in demographics due to war predisposed people to particular gender roles. According to Olah et al. (2018), women in the 1950s and 60s USA performed as housewives who did not engage in a professional job. On the contrary, men were commonly the breadwinners in the families.

Moreover, at that time, families were younger since people married and had children earlier in their life. Such tendencies have ultimately shaped the social factors in the assessed population of the elderly (Olah et al., 2018). In the 1970s, the gas crisis was a significant challenge for people due to the shortage of gas and the socio-economic implications of the political and economic climate in the USA (Thebault, 2021). Experiences like these shaped the populations environmental, emotional, physical health, and social well-being, which are essential to consider in the geriatric assessment.

Present Background

In contemporary US society, people aged 70 and older experience challenges in independent living and are often admitted to assisted living facilities. Ausubel (2020) cites one of the recent Pew Research Centers findings indicating that most US elderly citizens live either alone or in a couple. Moreover, the same research found that the elderly is likely to live in smaller households, and their socio-economic status is prevalently lower in comparison to other age groups (Ausubel, 2020). Importantly, the cultural background has its influence on the way people arrange their life at an older age. In particular, ethnic identity or religious affiliation predetermines independent family aging or admission to specialized facilities. For example, Hindu older individuals are more likely to live with their extended family, while families with weaker religious beliefs might be likely to admit their aging relatives to a geriatric facility. Moreover, more than 1.4 million people of older age reside in US nursing homes or long-term care facilities (Harrington et al., 2020). Given the recent and current Coronavirus pandemic, a prevalent percentage of such patients are exposed to the risks of Coronavirus and its complications.

Functional Factors

The decline in functionality is one of the most frequent characteristics of aging. In particular, the alterations and loss of functioning of such systems as vision, hearing, mobility, and independent daily activities performance adversely impact the experiences of the population aged 70 years and older. According to evidence, functional decline is associated with higher rates of institutionalization, increased mortality, and greater health care expenditure (Berg et al., 2021, p. 25). In this regard, it is essential for such individuals to be equipped with assistive items, such as hearing aid for hearing loss, glasses for vision assistance, and canes or other items for walking. Moreover, as claimed by Berg et al. (2021), the elderly is at a high risk of hospital-acquired functionality decline due to their frequent admission to care wards for health procedures. Thus, it is essential for the nursing staff to incorporate the multitude of factors contributing to the functionality level of each patient to provide care that meets their needs.

Health Issues

Another significant assessment element is health issues, which incorporates the conditions, illnesses, co-morbidities, and treatment methods that most frequently occur in the elderly. Due to the overall impairment to the body over the course of life, an aging individual is likely to encounter a range of mental and physical illnesses, which might be experienced concurrently. According, to Hiremath (2020), the most common health issues suffered by the representatives of the assessed age group include such physical conditions as high blood pressure, diabetes, cataracts, osteoarthrosis, joint and bone fractures, and hypertension. These issues arise from the decline in the quality of food and water consumed, environmental impact, and household tasks performance, which serve as additional factors to common aging processes (Hiremath, 2020). Moreover, family history, health records, quality of exercising, socio-economic status, and other determinants contribute to the prevalence of health issues.

Apart from the physical concerns, the elderly frequently suffers from particular mental illnesses. Research indicates that the most prevalent psychological problems encountered by the aging population include dementia, depression, isolation, Alzheimers disease, mood disorders, cognitive decline, and others (Hiremath, 2020). Patients who refer to health care professionals or who reside in specialized facilities are more likely to obtain relevant diagnoses and treatments of both physical and mental diseases. Specific intersectional multifaceted methods of treatment with the incorporation of the principles of drug compatibility are applied to manage older patients conditions. Indeed, it is imperative to note that medication treatments might have side effects that might impair other vulnerable bodily systems. Moreover, lengthy hospitalization might be associated with such complications as pressure ulcers, frequent falls, and an overall decline in functionality (Berg et al., 2021; Hiremath, 2020). However, isolated dwelling, low socio-economic status, and religious beliefs might serve as obstacles to quality and timely care for the elderly, which should be incorporated in the practices for raising health awareness among the individuals within this age group.

While the identified assessment result demonstrates common health issues experienced by an average representative of the assessed age group, they might be incomplete without specialized consultations of health care team members. In order to provide a substantial assessment of the different systems, an assessor might collaborate with cardiologists, dieticians, psychologists, traumatologists, ophthalmologists, and other narrow-specializing professionals to obtain a more in-depth assessment. Moreover, it is vital to incorporate a sociological viewpoint to assess how cultural and socio-economic particularities might be indicative of some health issues.

Emotional Well-Being

People aged 70 and older commonly live alone and suffer from loneliness due to the loss of their spouses. Within the context of the emotional well-being of the elderly, the issues of grief, isolation, anxiety, the lack of support and confidence are prevalent. Tseng and Hsu (2019) emphasize that emotional support is essential for the elderly; it is especially valued by those lacking family. Indeed, individuals in isolation are likely to develop depressive states, anxiety, and distress due to the burden of health. Importantly, the overcoming of the aging crisis when an older individual understands ones end-of-life situation, irreversible processes of aging, and generation gap impose significant emotional challenges (Tseng & Hsu, 2019). Therefore, it is essential to incorporate these assessment results in the process of the development of proper care methods.

Social, Economic, and Environmental Well-Being

Within the framework of assessing social issues experienced by elderly patients aged 70 and older, it is imperative to consider their relationships, dwelling, and communicative circles. In connection with emotional issues, social determinants are impacted by the tendency of older people to live alone without spouses at home or in assisted living facilities, or in nursing homes. Social aspects of the assessment are characterized by a lower rate of communicative activities and socialization exhibited by individuals who reside at home (Tseng & Hsu, 2019). Their social life is commonly characterized by family interactions and occasional peer meetings. Individuals residing in specialized facilities are more likely to engage in community activities, their socializing needs are more likely to be met by the staff.

Economically, the elderly are a vulnerable population due to their retirement. Ausubel states that the elderly in the USA live in residential areas that are smaller and cheaper. Moreover, according to the American Psychological Association (n. d.), since the common retirement age in the USA is 65, people aged 70 are retired. Their income depends on the benefits they obtain in the form of pension depending on their employment history. Within the environmental assessment of the aging population, one might note that such health issues as cancer, diabetes, and others related to environmental challenges prevail in patients aged 70 and older. Therefore, it is imperative to integrate these assessment results when developing preventative measures to reduce the environment-imposed threats of such concerns.

Conclusion

In summation, the conducted comprehensive geriatric assessment of the population aged 70 years and older allowed for identifying some most common experiences and issues. The overview of the historical background allowed for setting the experiences of these individuals in a proper context validating their gender-induced experiences and socio-economic conditions. The assessment of present background, health issues, emotional concerns, and socio-economic and environmental status demonstrated that the challenges associated with aging are omnipresent and are characterized by concurrent states. In order to provide relevant care, it is essential to incorporate the findings of this assessment in the work of multidisciplinary teams to implement intersectional, culturally sensitive, and diversity-driven practices. It will allow for preventing common diseases, assist in functionality decline, and address patients psychological and emotional needs.

References

American Psychological Association (n. d.). Fact sheet: Age and socioeconomic status. Web.

Ausubel, J. (2020) Older people are more likely to live alone in the U.S. than elsewhere in the world. Pew Research Center. Web.

Berg, A. E. V. D., Maas, J., Hoven, L. V. D., & Tanja-Dijkstra, K. (2021). Greening a geriatric ward reduces functional decline in elderly patients and is positively evaluated by hospital staff. Journal of Aging and Environment, 35(2), 125-144.

Harrington, C., Ross, L., Chapman, S., Halifax, E., Spurlock, B., & Bakerjian, D. (2020). Nurse staffing and coronavirus infections in California nursing homes. Policy, Politics, & Nursing Practice, 21(3), 174-186.

Hiremath, S. S. (2020). Socio-economic and health issues of the elderly: A case study. American Journal of Humanities and Social Science, 5, 1-8.

Olah, L. S., Kotowska, I. E., & Richter, R. (2018). The new roles of men and women and implications for families and societies. In A demographic perspective on gender, family and health in Europe (pp. 41-64). Springer, Cham.

Thebault, R. (2021). Long lines, high prices and fisticuffs: The 1970s gas shortages fueled bedlam in America. The Washington Post. Web.

Tseng, W. S. W., & Hsu, C. W. (2019). A smart, caring, interactive chair designed for improving emotional support and parent-child interactions to promote sustainable relationships between elderly and other family members. Sustainability, 11(4), 1-32.

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