WESSEX BGS Meeting, October 5th 2001 Comprehensive geriatric assessment Part 1 - eLearning Site of APLCGG

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WESSEX BGS Meeting, October 5th 2001 Comprehensive geriatric assessment Part 1 (1:46:26)

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標題

1. Comprehensive Geriatric Assessment

2. CGA – learning objectives

3. Older people are older ( rectangularisation to elongation of age distribution)

4. As a result…………

5. Older people are older ( rectangularisation to elongation of age distribution)

6. As a result…………

7. People with long-term conditions have high health service use, especially hospitals (69% total spend).

8. A snapshot of the older population

9. Concept of frailty and unstable disability

10. A snapshot of the older population

11. And then something happens to destabilise the situation

12. Slide 10

13. And then something happens to destabilise the situation

14. And then something happens to destabilise the situation

15. Clinical service implications

16. Slide 10

17. Identification & Measurement 1

18. Identification & Measurement 2

19. Identification & Measurement 3

20. Identification & Measurement 2

21. Identification & Measurement 3

22. Some examples of scales used

23. Properties of Scales

24. Reliability

25. Responsiveness

26. Sensitivity

27. Examples of properties matched to purpose of using the scale

28. ExerciseDomain?Type of scoring?Purpose?Reliable?Sensitive?

29. Using Assessment for Targeting

30. Risk assessment in healthcare

31. STRATIFY properties

32. STRATIFY properties

33. Can it be used in practice?

34. Comprehensive Old Age (Geriatric) Assessment (CGA)

35. What domains do we need to assess?

36. Comprehensive Old Age (Geriatric) Assessment (CGA)

37. What domains do we need to assess?

38. Comprehensive Old Age (Geriatric) Assessment (CGA)

39. Uses of CGA

40. Community based CGA – EvidenceMRC trial (Fletcher A et al, Lancet 2004)

41. Community based CGA – EvidenceMRC trial (Fletcher A et al, Lancet 2004)

42. Meta-analysis of 28 RCTs A.Stuck et al, 1993

43. Ageing population and acute hospitals

44. Meta-analysis of 28 RCTs A.Stuck et al, 1993

45. Meta-analysis of 28 RCTs A.Stuck et al, 1993

46. Ageing population and acute hospitals

47. Disability after acute illness

48. The Vicious Cycle of Dependency

49. Functional change also creates instability

50. Clinical tasks needed

51. Functional decline at discharge from hospital in randomised trials comparing acute geriatric units with conventional hospital

52. Living at home after discharge from hospital at 3 months in randomised trials comparing acute geriatric units with conventional hospital care

53. Eg. The GSTT OPAL team

54. Who do we focus on?

55. Comprehensive geriatric assessment for older adults admitted to hospital.

56. Results

57. Example –Post acute recovery and rehabilitation

58. Summary

59. Slide 46

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