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E-book Comprehensive Geriatric Assesment Toolkit for Primary Care Practitioners
Comprehensive Geriatric Assessment (CGA) is a process of care comprising a number of steps. Initially, a multidimensional holistic assessment of an older person considers health and wellbeing and leads to the formulation of a plan to address issues which are of concern to the older person (and their family and carers when relevant). Interventions are then arranged in support of the plan. Progress is reviewed and the original plan reassessed at appropriate intervals with the interventions reconsidered accordingly. Some bodies prefer to call it a comprehensive older age assessment (COAA). It is also referred to as geriatric evaluation management and treatment (GEMT). It is a form of integrated care and is an example of a complex intervention. Evidence shows that CGA is effective in reducing mortality and improving independence (still living at home) for older people admitted to hospital as an emergency compared to those receiving usual medical care. In community settings, the evidence shows that complex interventions in people with frailty can reduce hospital admission and can reduce admission in those recently discharged and can reduce the risk of readmission in those recently discharged. CGA is also a vital part of the management
strategy for older people suspected of having frailty in order to identify areas for improvement and support to reduce the impact of frailty. A recent study showed that comprehensive
assessment and individualised care planning can reverse the progression of frailty. The CGA process requires co-ordination to ensure that the experience is positive for both the
patient and their families. As older people’s needs are frequently complex and always unique, those co-ordinating the process must display advanced communication skills in addition to their clinical knowledge to ensure purposeful and timely assessment. Therefore co-ordination of CGA can be undertaken by any member of the health and social care team but is best carried out by someone the patient and their family trusts and with whom they can have open and sensitive discussions.
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