Geriatric Care in the Community Setting: Comprehensive Geriatric Assessment.

A comprehensive geriatric assessment (CGA) is a systematic, multidisciplinary evaluation of older adult patients with the goal of identifying and managing geriatric conditions and syndromes. It focuses on various medical, social, and environmental issues. A CGA ideally is performed as an in-person outpatient visit, either in a clinical setting or the home of the patient. The physician, family members and/or caregivers, and a social worker are key contributors. Involvement of family members or caregivers particularly is important if cognitive issues or mood disorders are of concern. Physical therapists, occupational therapists, nurses, speech-language pathologists, dietitians, audiologists, and pharmacists also can provide additional expertise. Many questionnaires and assessment tools are available to simplify data gathering, including assessments of functional status, frailty, mobility, fall risk, nutritional status, polypharmacy, and cognition. These assessments can be completed by patients, family members, or caregivers with assistance from members of the medical team. CGAs should be guided by the Geriatric 5M's framework: mind, mobility, medications, multicomplexity, and matters most. A systematic review of these elements can help identify areas of need and requirements for support for older adult patients.

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