Ateneo de Zamboanga University

College of Nursing

NCM 114j

Care of the Older Adults

Geriatric Assessment

Name :_________________________________ Score

Section :________________________________

Instruction: Assess an older Adult age 60 and above. It maybe your grandparents , or a family
member, or an elder in the neighborhood.. base on the assessment guide below in term of
History, Physiologic , Functional level be it ADL or IADL and Depression Scale . From the
Assessment below Write at least five (5) Nursing Diagnosis and Five health Teachings ton keep
the older person maintain a satisfactory and Happy life.

Patient Name : (Initial)

Age :
Ethnic :
Religion :
Marital Statius :
Educational Attainment:
Support System :
Source of Income :

GERIATRIC ASSESSMENT
History
Present medical History- Current Diagnosis/Chronic Illness
a. Medical History Past medical
Surgeries
treatment
a. Drug History Medications taken
Tobacco alcohol use
b. Nutrition History Type of diet .variety, quantity, use of vitamins, weight, problems
in chewing swallowing ,taste , smell
c. Mental Health Insomnia, mood changes, cognitive changes
d. Social History Living arrangements, financial status, hobbies, socialization,
support system

NCM 114 Geriatric Assessment

 Assessment- Physical Examination
Vital Signs T,P,R, BP
Integumentary Texture, turgor, Skin problems
Skin Injury, color hydration, nails, capilliary refill, hair. Head and
neck

Sensory function Hearing, vision, touch, taste and smell

Respiratory Function Assess difficulty and anxieties associated with breathing
Histories of smoking behavior and exposure to environmental
pollutants, Posture , breatlessness, chest sounds
Any Chest xray, sputum analysis, pulmonary function test
Circulatory Function Chestpain, discomfort, fatigue
ECG
Gastrointestinal Function Oral health assessment, oral health practice, appetite and
changes in appetite, nausea ang vomiting , stomach
discomfort , bowel elimination
Genito urinary function urinary symptoms, pap smear,, difficulties related the
frequency voluntary flow of urine , for men enlarge prostrate ,
Musculoskeletal function Posture and walking, Gait assistive device
Any report on osteoarthritis , muscle strenght
Reproductive Function Menstruation, Abnormal bleeding, vaginal discharge
Neurological Symptoms Sleep disturbance, tremors seizures, previous and current
impairment in speech, expression, swallowing, memory,
orientation, energy level balance, sensation and motor function
FUNCTIONAL ASSESSMENT
Ability Abiltity to perform self care, self maintenance and physical
abilities. Ambulations
Disability Impact that health problems have on the individuals ability to
perform task, roles and activities

Activities of Daily Living Index

Katz Index of Independence in Activities of Daily Living

Activities Independence Dependence

Points (1 or 0) (1 Point) NO supervision, (0 Points)
direction or personal WITH supervision, direction,
assistance. personal assistance or total
care.

BATHING (1 POINT) Bathes self (0 POINTS) Need help with

Points: __________ completely or bathing more than one part of
needs help in bathing only a the

NCM 114 Geriatric Assessment


DRESSING
Points: __________
TOILETING
Points: __________
TRANSFERRING
Points: __________
CONTINENCE
Points: __________
FEEDING
Points: __________
TOTAL POINTS: ________ SCORING: 6 = High (patient independent) 0 = Low (patient
very dependent
Source:
try this: Best Practices in Nursing Care to Older Adults, The Hartford Institute for Geriatric
Nursing, New York University
INSTRUMENTAL ACTIVITIES OF DAILY LIVING: Incircle the Number of each scale and
add the Total to get the IADL ability of the Patient
NCM 114 Geriatric Assessment
single part
of the body such as the back,
genital
area or disabled extremity.
(1 POINT) Get clothes from
closets
and drawers and puts on
clothes and
outer garments complete with
fasteners.
May have help tying shoes.
(1 POINT) Goes to toilet,
gets on and
off, arranges clothes, cleans
genital area
without help.
(1 POINT) Moves in and out
of bed or
chair unassisted. Mechanical
transfer
aids are acceptable
(1 POINT) Exercises
complete self
control over urination and
defecation.
(1 POINT) Gets food from
plate into
mouth without help.
Preparation of food
may be done by another
person.
body, getting in or out of the
tub or
shower. Requires total
bathing
(0 POINTS) Needs help with
dressing self or needs to be
completely dressed.
(0 POINTS) Needs help
transferring to the toilet,
cleaning
self or uses bedpan or
commode.
(0 POINTS) Needs help in
moving
from bed to chair or requires
a
complete transfer.
(0 POINTS) Is partially or
totally
incontinent of bowel or
bladder
(0 POINTS) Needs partial or
total
help with feeding or requires
parenteral feeding.
NCM 114 Geriatric Assessment
 LAWTON - BRODY
INSTRUMENTAL ACTIVITIES OF DAILY LIVING SCALE (I.A.D.L)
Scoring: For each category, circle the item description that most closely resembles the
client’s highestlevel (either 0 or 1)
A. Ability to use the Telephone
1. Operates telephone on own initiative-looks up and dials numbers, etc. 1
2. Dials a few well-known numbers 1
3. Answers telephone but does not dial 1
4. Does not use telephone at all 0
B. Shopping
1. Takes care of all shopping needs 1
independently 1
2. Shops independently for small purchases 1
3. Needs to be accompanied on any shopping trip 0
4. Completely unable to shop 0
C. Food Preparation
1. Plans, prepares and serves adequate meals independently 1
2. Prepares adequate meals if supplied with ingredients 0
3. Heats, serves and prepares meals, or prepares meals, or prepares meals 0
but does not maintain adequate diet
4. Needs to have meals prepared and served 0
D. Housekeeping
1. Maintains house alone or with occasional assistance (e.g. "heavy work 1
domestic help")
2. Performs light daily tasks such as dish washing, bed making 1
3. Performs light daily tasks but cannot maintain acceptable level of 1
cleanliness 1
4. Needs help with all home maintenance tasks 0
5. Does not participate in any housekeeping tasks
E. Laundry
1. Does personal laundry completely 1
2. Launders small items-rinses stockings, etc. 1
3. All laundry must be done by others 0
F. Mode of Transportation
1. Travels independently on public transportation or drives own car 1
2. Arranges own travel via taxi, but does not otherwise use public 1
transportation 1
3. Travels on public transportation when accompanied by another 0
4. Travel limited to taxi or automobile with assistance of another 0
5. Does not travel at all
G. Responsibility to Own Medications
1. Is responsible for taking medication in correct dosages at correct time 1
2. Takes responsibility if medication is prepared in advance in separate 0
dosage 0
3. Is not capable of dispensing own medication
H. Ability to handle Finances
1. Manages financial matters independently (budgets, writes checks, pays 1
rent, bills, goes to bank), collects and keeps track of income
2. Manages day-to-day purchases, but needs help with banking, major 1
NCM 114 Geriatric Assessment
purchases, 0
3. Incapable of handling money
TOTAL SCORE
A summary score ranges from 0 (low function, dependent) to 8 (high function,
Geriatric Depression Scale
15-Item Geriatric Depression Scale (GDS-15)
Are you basically satisfied with your life? (yes) or (No)
Have you dropped many of your activities and interests? (yes) or (No)
Do you feel that your life is empty? (yes) or (No)
Do you often get bored? (yes) or (No)
Are you in good spirits most of the time? (yes) or (No)
Are you afraid that something bad is going to happen to you? (yes) or (No)
Do you feel happy most of the time? (yes) or (No)
Do you often feel helpless? (yes) or (No)
Do you prefer to stay at home, rather than go out and do new (yes) or (No)
things?
Do you feel you have more problems with memory than most? (yes) or (No)
Do you feel pretty worthless the way you are now? (yes) or (No)
Do you think it is wonderful to be alive? (yes) or (No)
Do you feel full of energy? (yes) or (No)
Do you feel that your situation is hopeless? (yes) or (No)
Do you think that most people are better off than you are? (yes) or (No)
15-Item GDS score Score
(Score 1 for answers in block capitals: 0-4 yes normal, 5-9 Mild
depression, 10-15 More severe depression)
Dr Yesavage has confirmed that the original scale (from which the calculator has been derived) is in the public domain due to it
being partly the result of US Federal support.
The 15-item (GDS-15) and 4-item (GDS-4) versions of the GDS are good methods of screening for major depression (as is the 10-
item version). The shorter of these (GDS-4) is of limited clinical value in monitoring the severity of the depressive episode (may be
better used to exclude depression).[4] The systematic use of short GDS versions in Primary Care may increase detection rates of
depression among the elderly.[5]

NURSING DIAGNOSIS
1.
2.
3.
4.
5

Health Teachings
1.
2.
3.
4.
5.

Formulate 1 NCP based on the Nursing diagnosis

NCM 114 Geriatric Assessment