Download the Comprehensive Geriatric Assessment Pocket Card

Items in (red) are recommended for initial comprehensive geriatric assessment

Geriatric Assessment
Big 10 Principle Recommended Screens Further Assessment for Positive Screen
SOCIAL Social Support 5, 9 Do you live alone?
Do you have a caregiver?
Are you a caregiver?

Consider referral to social worker

Refer to area Agency on Aging
Atlanta (404) 463-3333

Elder Neglect/Abuse 5, 6 Do you ever feel unsafe where you live?
Has anyone ever threatened or hurt you?
Has anyone been taking your money without your permission?

Social Work Assessment

Consider Adult Protective Services referral

Advance Directives 10 Would you like information or forms for a power of
attorney for healthcare?
Would you like information on a living will?

Discussion on advance directives

FUNCTIONAL Functional Status 4, 6 Do you need assistance with shopping or finances?
Do you need assistance with bathing or taking a shower?

Instrumental ADL Scale

Basic ADL Scale

Driving 4, 6

Do you still drive? If yes:
While driving, have you had an accident in the past 6 months?
Driving concerns by family member?

Vision testing

Consider Occupational Therapy evaluation

Driving Concerns by family member

Vision 1, 3, 4 Do you have trouble seeing, reading, or watching TV? (with glasses, if used)

Vision testing

Consider referral to optometry or opthalmology

Hearing 1, 3, 4 Do you have difficulty hearing conversation in a quiet room?
Unable to hear whisper test 6-12
inches away?

Cerumen check and removal if impacted

Consider Audiology referral

GERIATRIC SYNDROMES Medications 2, 8 Are you prescribed > 5 routine medications?
Do you have difficulty understanding the reason for each of your medications?

Match medications with diagnoses in problem list

Consider reducing doses or discontinuing drugs

Fall Risk 2, 3, 6 Have you fallen in the past year?
Are you afraid of falling?
Do you have trouble climbing stairs or rising from chairs?

"Get Up and Go" test

Consider full Fall Assessment

Consider Physical Therapy Evaluation

Consider Home Safety Assessment

Continence 2, 3 Do you have any trouble with your bladder?
Do you loose urine when you do not want to?
Do you wear pads or adult diapers?

Consider full Continence Assessment

AUA 7 symptom inventory (men)

Weight Loss 2, 3 Weight < 100 lbs, or
Unintentional weight loss > 10 pounds over 6 months?

Simplified Nutritional Appetite Questionnaire (SNAQ)

Consider Nutrition evaluation

Sleep 2, 3 Do you often feel sleepy during the day?
Do you have difficulty
falling asleep at night?

Epworth Sleepiness Scale

Consider referral for sleep evaluation

Review good sleep hygiene

Pain 2, 3 Are you experiencing pain or discomfort?

Pain Assessment

Alcohol Abuse 3, 5 Do you drink > 2 drinks / day?

CAGE Questionnaire

COGNITION AND AFFECT Depression 7 Do you often feel sad or depressed?
Have you lost pleasure in doing things over the past few months?

Geriatric Depression Scale

Cognition 7 Self reported memory loss?
Cognitive Screen positive? (3-item
recall and Clock Draw test)

Mini Mental Status Exam

Consider Neuropsychological testing