Synopsis
Use comprehensive geriatric assessment to convert medical, functional, psychological, medication, social and personal-priority findings into one coordinated plan that treats acute disease, protects independence and names accountable follow-up.
- CGA is a multidimensional, interdisciplinary diagnostic and planning process with implementation and review; a long clerking or screening form alone is not CGA.
- First priority remains diagnosis and treatment of acute illness. Build CGA alongside emergency care and revise it as delirium, pain and physiology improve.
- Establish baseline about two weeks before the acute illness from the person and collateral sources: mobility, ADLs, IADLs, cognition, mood, continence, nutrition and support.
Key red flags
New confusion, reduced alertness or behaviour change is delirium until assessed and requires a cause search rather than attribution to dementia or old age.
Falls, delirium, immobility, incontinence or poor intake may be the first expression of infection, stroke, medicine toxicity, pain or organ failure.
Investigation priorities
Identify time-critical and reversible disease before attributing change to frailty.
Management branches
An older adult presents with acute illness, functional decline or complex discharge needs.
- Treat immediate physiological threats and obtain essential collateral, baseline function and medicine information in parallel.
- Assess medical, functional, psychological, sensory, social and personal-priority domains with the relevant MDT members.