GERIATRIC GLOBAL VALUATION

GERIATRIC GLOBAL VALUATION is a diagnostic process dynamic and structured which allows to detect and quantify the problems, needs and capabilities of the elderly in the clinical, functional, social and mental areas.The main objetive is to improve the patient's quality of life.

The main elements to perform a correct assessment are:

• Anamnesis
• Physical examination
• The most useful tools which serve as support to conduct a Geriatric Global Valuation are the SCALES.

I think that the anamnesis is very important to discover the patient's limitations such as sensorial problems, mobility limitations, cognitive impairment and the other health problems which affect to patient's quality of life. For this reason, the clinical interview should be short, speak clearly and above all, allow more time to the patient's responses.

PHYSICAL AREA

It's focused to find the presence of GERIATRIC SYNDROMES through the interview and physical examination.

1. Immobility 
2. Pressure Ulcer 
3. Demetia/confusion 
4. Depression
5. Instability 
6. Malnutricion
7. Incontinence
8. Iatrogenesis
9. Fecal impaction
10. Inmunedeficiency
11. Sensorial impairment
12. Indigence 
13. Terminal illness

FUNCTIONAL AREA

This area is the most important for me, because it evaluates the persons's independence level. It's based on:

• Basic activities of daily living such as eat, walk, dress up/undress,communication, continence, ambulation, rest... 

SCALES: 

1. KATZ'S INDEX
2. BARTHEL'S INDEX
3. PHYSICAL DISABILITY OF CRUZ ROJA SCALE
4. PLUTCHIK'S SCALE

• Instrumental activity such as write/read, cook, shops,use the phone, clean, transport, administration of drugs, housework, climbing stairs...

SCALES: 

1. LAWTON AND BRODY'S INDEX.

MENTAL-SOCIAL AREA

Mental area valutes the presence of mental disorder in the elderly. I think that is very important too because the 25% of geriatric patients have some type of psychiatric disorder. Therefore, nursing should have a mental examination as a screening to detect any pathology.

SCALES:

1. SHORT PORTABLE MENTAL STATUS QUESTIONNAIRE
2. MINI-MENTAL STATE EXAMINATION OF FOLSTEIN
3. GLOBAL DETERIORATION SCALE OF REISBERG
4. MINI EXAM COGNITIVE OF LOBO
5. CLOK TEST

Social area allows to know the relationship between the geriatric person and his environment.
Family and social support are the most important issues in this area.

SCALES:

1. OARS SCALE

AFFECTIVE AREA 

Anxiety and depression are disease very prevalent in the elderly because it a life's stage where many losses occur, such as couple's death, friend's death, health's loss, low economic resources and another social problems.

SCALE:

1. GERIATRIC DEPRESSION SCALE OF YESAVAGE.