Patient Profile
Individualized consultation nonemergency patient
Comprehensive patient assessment
How is a comprehensive patient assessment done?
What is Geriatrics?
Geriatrics is the medical specialty which focuses on the care and treatment of the elderly, usually patients who are 65 years of age or older.
What is the profile of the patient who needs doctor consultation?
Take a look at this.
Geriatric Consultation
Questions you need to answer.
Question 2
What is your name?
Question 3
What is your date of birth?
Question 4
What is your mailing address?
Question 5
What is your telephone number?
Question 6
Where is the patient now?
Question 7
How old is the patient?
Question 8
What is the gender of the patient?
Question 9
What are the sources of medical history?
Question 10
What best describes the patient?:
Question 11
In general, how is your physical and mental health?
Question 12
Do you have any appointments scheduled with doctors or other specialists?
Yes
No
Question 13
Have you been in the hospital in the last month?
Yes
No
Question 14
Do you have health problems that you need help with right away?
Yes
No
Question 15
Do you need extra help to access services, such as a wheelchair ramp, a computer screen reader or large print materials?
Yes
No
Question 16
Screening for survival needs
Do you have enough of these resources from the state?
Food
Clothing
Housing
Health care
Transportation
Security
Education
Consumer goods
Communication
Do you need any of these resources to be enhanced?
Question 17
What are the issues?
Question 18
Is your complete medical history ready?
Yes
No
Question 19
Primary Care Physician Name, Address and Phone:__________________
Emergency Contact Name:______________
Relationship:________________________
Question 20
Your Height:_________________________
Your Weight:_________________________
Question 21
Referred by:_________________________
Question 22
What seems to be the problem?
Question 23
What is the reason for consultation?
Question 24
What best describes problem of the patient?
Sleep problems.
Anger.
Relationship problem.
Not taking care of self.
Not taking care of others.
Misinterpreting the facts.
Recent social withdrawal or loss of interest in others.
Illogical thinking typical of childhood but in an adult.
Repeatedly checking or doing activities that seem abnormal.
Restlessness.
Administrative abuse/harms from others.
Thoughts or threats to hurt oneself or others.
Social withdrawal after death of a person known to the patient.
Communication problem (speech, writing, reading, expression).
Not enough food, clothing, housing needs, transportation, health care, or education.
Other issues.
You need to give details of the issues or problems.
Life-threatening conditions.
Suicidal thoughts.
Homicidal thoughts.
Assault, violent actions or behavior.
Delirium or extreme agitation.
Feeling that harms have been inflicted or are being inflicted, and that harms are going to be inflicted that need to be prevented.
Question 25
Is the claim any one of these?
Psychological torture
Physical torture
Corruption in politics of regulations
Racism
Deprivations of rights under the color of law
Political abuse
Discrimination
Disruption
Exclusion
Question 26
Did anyone beat or torture you at any point since birth?
Question 27
Is there any incident or issue in past, present, or future that is causing distress to you?
Question 28
Did you experience any one of these that has troubled you since the day you were born?
Assault.
Accidents.
Child abuse or captivity.
Childbirth.
Death of a loved one.
Fire.
Rape.
Natural disaster (hurricanes, earthquakes, tsunamis).
Road traffic crash.
Building collapse.
Fire.
Shooting.
Neglect of a child leading to a serious harms.
Domestic violence.
War.
Genocide.
Torture.
If yes, what are the details?
If any other traumatic, stressful, harmful, or horrifying event, give more details.
Question 29
What conditions require emergency psychiatry consultation?
1. Attempted suicide.
2. Attempted homicide.
3. Substance abuse. v
4. Psychosis(delusions, hallucinations, catatonia, thought disorder, loss of contact with reality).
5. Suicidal thoughts, homicidal thoughts.
6. Violence or other rapid changes in behavior.
7. Abuse.
8. Environmental factors (hostile environment).
9. Functional impairment (not taking care of self. inability to gain relevant skills and knowledge relevant to age).
10. Personality disorders (harmful to others).
11. Panic attacks.
12. Loosening of social inhibitions.
13. Likely to be harmful to self or others.
14. Serious drug reactions with psychiatric or non-psychiatric medications.
15. Intentional enforced harms.
16. Other.
Here are further guidelines.
Aggressive
Anger
Anxiety
Avoidance of situations
Being unable to limit the amount of alcohol you drink
Blunted
Building a tolerance so that you need an increasing number of drinks to feel the effects
Carelessness about personal grooming
Change in appetite
Changed sleeping pattern
Changes in Behavior – Sleep disturbance
Changes in Emotion and Motivation
Changes in Thinking and Perception
Chest pain
Choking
Chronic fatigue, lack of energy
Confusion
Constipation
Crying spells
Decrease concentration and memory
Decreased appetite
Decreased coordination
Delusions
Depression
Depression as the drug wears off
Diarrhea, muscle aches
Difficulties with concentration or attention
Difficulty concentrating
Distress in social situations
Dizziness
Drinking alone or in secret
Drowsiness
Dry mouth
Elated mood
Especially if alcohol isn't available
Euphoria
Experiencing physical withdrawal symptoms such as nausea, sweating and shaking
Feeling a need or compulsion to drink
Feeling that self or others have changed or are acting different in some way
Flashbacks, a re-experience of the hallucinations — even years later
Flat or inappropriate emotion
Flushing
Frequent self-criticism
Grandiose delusions
Greatly impaired perception of reality, for example, interpreting input from one of your senses as another, such as hearing colors
guilt
Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel "normal"
Hallucinations
Having legal problems
Having problems with relationships
Headache, sweating
Heart palpitations
Helplessness
High blood pressure
Hopelessness
Hyperventilation
Impaired memory and concentration
Impaired motor function
Impatience
Increased appetite
Increased blood pressure and heart rate
Increased energy and overactivity
Increased heart rate
Increased heart rate, blood pressure and temperature
Indecisiveness and confusion
Indecisiveness, irritability
Insomnia
Irregular menstrual cycle
Irritability
Irritability when your usual drinking time nears
Keeping alcohol in unlikely places at home
Lack of coordination
Lack of emotional responsiveness
Lack of energy, overeating or loss of appetite
Lack of inhibitions
Lack of insight.
Losing interest in activities and hobbies that used to bring pleasure
Loss of appetite
Loss of interest in hobbies, sports, and other favorite activities
Loss of interest in personal appearance(Social grooming)
Loss of memory
Loss of motivation, chronic fatigue
Loss of motivation, drug or alcohol use
Loss of sexual desire
Making a ritual of having drinks before, with or after dinner and becoming annoyed when this ritual is disturbed or questioned
Memory impairment
Mind racing or going blank
Mood swings
Nasal congestion and damage to the mucous membrane of the nose in users who Snort drugs
Nausea and vomiting
Nausea, vomiting
Needing less sleep than usual
Needle marks (if injecting drugs)
Neglect of responsibilities
Not remembering conversations or commitments, sometimes referred to as blacking out
Numbness
Obsessive or compulsive behavior
Overeating or loss of appetite
Panic
Paranoia
Paranoid thinking
Permanent mental changes in perception
Phobic behavior
Poor memory
Rapid heartbeat
Rapid speech
Rapid thinking and speech
Red eyes
Red or glassy eyes
Reduced ability to carry out work or other roles.
Reduced energy and motivation
Reduced sense of pain
Restlessness
Restlessness or feeling “on edge” or nervousness
Runny nose
Sadness
Sedation
Self-blame, pessimism
Self-criticism, self-blame, pessimism
Sense of alteration of self
Sensory Changes(A heightened sense of visual, auditory and taste perception.
A reduction or greater intensity of smell, sound or color)
Shortness of breath
Sleep disturbance
sleeping too much or too little
Slowed breathing
Slowed breathing and decreased blood pressure
Slowed reaction time
Slurred speech
Social isolation or withdrawal
Strange ideas
Sudden change in behavior
Sudden mood swings
Suspiciousness
Tendency to believe others see you in a negative light
Thoughts of death and suicide
Tingling and numbness
Tiredness
Tremors
Tremors/shaking
Unexplained aches and pains
Unrealistic and/or excessive fear and worry
Unusual perceptual experiences
Violent Behavior
Vivid dreams
Weight loss
Weight loss or gain
Withdrawal from family members and/or long-term friends
Withdrawal from others
Worrying
Question 33
Where is the patient the day and date you are writing these details?
Question 34
Do you have difficulty with eyesight?
Common age-related vision complaints include:
* "I can't see as clearly as I used to."
* "I have difficulty seeing objects close up."
* "Colors don't seem as vivid."
* "It's getting more difficult to see in the dark."
* "I'm less able to adapt to glare."
* "I need more light to see."
* "Have trouble seeing well enough to do everyday tasks like reading, cooking, or sewing."
* "Can't recognize the faces of friends or family."
* "Have trouble reading street signs."
* "Find that lights don't seem as bright."
Question 35
Have you had any falls in the last year?
Question 36
Do you have trouble with stairs, lighting, bathroom hazards, or other home hazards?
Question 37
Do you have a problem with urine leaks or accidents?
Question 38
Over the past month, have you often been bothered by
feeling sad, crying, angry, depressed, or hopeless?
Question 39
During the past month, have you often been bothered by little interest or pleasure in doing things?
Question 40
Do you ever feel unsafe where you live?
Question 41
Does anyone threaten you or hurt you?
Question 42
Is pain a problem for you?
Question 43
Impairment Rating and Disability Determination
Health status
How would you describe your health status relevant to your age?
_________________________
100% mentally fit.
100% physically fit.
Do you have any problems with activities mentioned below relevant to your age?
Walking
Seeing
Hearing
Speaking
Breathing
Learning
Working
Caring for oneself (eating, dressing, toileting, bathing, toothbrush, washing, doing laundry, transportation, transferring out of bed, shopping, fast walking, cooking, etc.)
Performing manual tasks
Getting started after sleep
Sitting
Sleeping
_________________________
____________________________________________
Who assists?
____________________________________________
Question 44
Do you use any devices?(for "yes" answers, consider causes, social services, and home eval/Physical Therapy/Occupational Therapy)
Question 45
What are the sources of medical history?
Patient _______
Other_______
Patient Name: _______
Date: _______
Question 46
Have you had any falls in the last year?
Question 47
Do you have trouble with stairs, lighting, bathroom hazards, or other home hazards?
Question 48
Do you have a problem with urine leaks or accidents?
Question 49
Over the past month, have you often been bothered by
feeling sad, crying, angry, depressed, or hopeless?
Question 50
During the past month, have you often been bothered by little interest or pleasure in doing things?
Question 51
Geriatric Depression Scale (Short Form)
For each question, choose the best answer for how you felt over the past week.
1. Are you basically satisfied with your life? Yes / NO
2. Have you dropped many of your activities and interests? YES / No
3. Do you feel that your life is empty? YES / No
4. Do you often get bored? YES / No
5. Are you in good spirits most of the time? Yes / NO
6. Are you afraid that something bad is going to happen to you? YES / No
7. Do you feel happy most of the time? Yes / NO
8. Do you often feel helpless? YES / No
9. Do you prefer to stay at home, rather than going out and doing new things? YES / No
10. Do you feel you have more problems with memory than most? YES / No
11. Do you think it is wonderful to be alive now? Yes / NO
12. Do you feel pretty worthless the way you are now? YES / No
13. Do you feel full of energy? Yes / NO
14. Do you feel that your situation is hopeless? YES / No
15. Do you think that most people are better off than you are? YES / No
The scale is scored as follows: 1 point for each response in capital letters. A score of 0 to 5 is normal; a score above 5 suggests depression.
Question 52
Instrumental Activities of Daily Living (Self-Rated Version)
For each question, circle the points for the answer that best applies to your situation.
1. Can you use the telephone?
Without help 3
With some help 2
Completely unable to use the telephone 1
2. Can you get to places that are out of walking distance?
Without help 3
With some help 2
Completely unable to travel unless special arrangements are made 1
3. Can you go shopping for groceries?
Without help 3
With some help 2
Completely unable to do any shopping 1
4. Can you prepare your own meals?
Without help 3
With some help 2
Completely unable to prepare any meals 1
5. Can you do your own housework?
Without help 3
With some help 2
Completely unable to do any housework 1
6. Can you do your own handyman work?
Without help 3
With some help 2
Completely unable to do any handyman work 1
7. Can you do your own laundry?
Without help 3
With some help 2
Completely unable to do any laundry at all 1
8a. Do you take any medicines or use any medications?
Yes (If "yes," answer question 8b.) 1
No (If "no," answer question 8c.) 2
8b. Do you take your own medicine?
Without help (in the right doses at the right time) 3
With some help (take medicine if someone prepares it for you and/or reminds you to take it) 2
Completely unable to take own medicine 1
8c. If you had to take medicine, could you do it?
Without help (in the right doses at the right time) 3
With some help (take medicine if someone prepares it for you and/or reminds you to take it) 2
Completely unable to take own medicine 1
9. Can you manage your own _____?
Without help 3
With some help 2
Completely unable to handle _______ 1
Question 53
Problem Screening measure Positive screen
Vision Ask this question: "Because of your eyesight, do you have trouble driving a car, watching television, reading or doing any of your daily activities?"
If the patient answers "yes," test each eye with the Snellen eye chart while the patient wears corrective lenses (if applicable). "Yes" to question and inability to read at greater than 20/40 on the Snellen eye chart
Hearing Use an audioscope set at 40 dB. Test the patient's hearing using 1,000 and 2,000 Hz. Inability to hear 1,000 or 2,000 Hz in both ears or inability to hear frequencies in either ear
Leg mobility Time the patient after giving these directions: "Rise from the chair. Then walk 20 feet briskly, turn, walk back to the chair and sit down." Unable to complete task in 15 seconds
Urinary incontinence Ask this question: "In the past year, have you ever lost your urine and gotten wet?"
If the patient answers "yes," ask this question: "Have you lost urine on at least 6 separate days?" "Yes" to both questions
Nutrition and weight loss Ask this question: "Have you lost 10 pounds over the past 6 months without trying to do so?"
If the patient answers "yes," weigh the patient. "Yes" to the question or a weight of less than 45.5 kg (100 lb)
Memory Three-item recall Unable to remember all three items after 1 minute
Depression Ask this question: "Do you often feel sad or depressed?" "Yes" to the question
Physical disability Ask the patient these six questions:
"Are you able to do strenuous activities, like fast walking or bicycling?"
"Are you able to do heavy work around the house, like washing windows, walls or floors?"
"Are you able to go shopping for groceries or clothes?"
"Are you able to get to places that are out of walking distance?"
"Are you able to bathe--sponge bath, tub bath or shower?"
"Are you able to dress, like put on a shirt, button and zip your clothes, or put on your shoes?"
"No" to any of the questions
Question 54
Do you have difficulty with eyesight?
Yes
Refer
Snellen chart
Can't read 20/40
Test each eye (with glasses)
Question 55
Whisper short sentence from 6-12 inches (out of view) or audiometery
Unable to hear
Cerumen check
Refer
5Touch the back of your head with your hands
Unable to do either
Further examination
Question 56
Rise from your chair (do not use arms to get up), walk 10 feet, walk back to the chair, and sit down.
Observed problem, or unable to perform in <15 seconds
Formal balance and gait evaluation; further examination; home evaluation and physical therapy
Question 57
Have you had any falls in the last year?
Question 58
Formal balance and gait evaluation
Do you have trouble with stairs, lighting, bathroom, or other home hazards?”
Yes to any
Question 59
Home evaluation, physical therapy
Body mass index <21 or weight loss exceeding 5%
Yes to either
Nutrition evaluation
Question 60
Incontinence evaluation
Do you have a problem with urine leaks or accidents?”
Yes
Question 61
Name three objects: ask again in three minutes
Unable to recall
Mini-Mental State Evaluation
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Other.
I have read and agree to the Terms & Conditions.
These are basic questions.
There are many more.
What is Geriatrics?
What is a geriatrician?
How can you make a difference for your parents or older adults from a distance?
What are your duties if you live in the same household as those more than 65 years old?
What are your duties if you live in the neighborhood as those more than 65 years old?
What are your duties if you are away from you parent(s) or adults more than 65 years old and need to make a difference?
What are the duties of the state department of health in caring for adults more than 65 years old?
What should adults more than 65 years old know about aging?
Where is the patient the day and date you are writing these details?
What is the best way to help elders more than 65 years old?
What is my immediate advice to elders?
What must you do if you need emergency consultation for older adults?
What do you need to do if you need non-emergency consultation for older adults?
How is aging measured?
What are in comprehensive tests before prescribing a treatment regimen. What do the tests involve?
What is an average treatment regimen?
What is involved in harmone replacement therapy?
What are cognitive enhancers?
What is the History of anti-aging?
How old do you have to be to benefit from the skills of a geriatrician?
What is a geriatrician?
A geriatrician is a medical doctor who is specially trained to prevent and manage the unique and, oftentimes, multiple health concerns of older adults. Older persons may react to illness and disease differently than younger adults. Geriatricians are able to treat older patients, manage multiple disease symptoms, and develop care plans that address the special health care needs of older adults.
If you are getting older and having more health problems you may want to consider seeing a doctor who specializes in geriatric medicine. This specialty is increasing in importance as the population ages and that aging population lives longer.
A geriatrician is a doctor who specializes in care for people 65 and older. Just as a pediatrician tends to the needs of a child, a geriatrician cares for the special needs of changing seniors. Geriatricians approach each patient’s needs individually, and possess the knowledge and expertise needed to accommodate seniors.
The most appropriate term for a physician who specializes in the care of older adults is geriatrician, not gerontologist. A gerontologist is generally a non-physician, though physicians who focus on aging research can also be considered gerontologists.
How can you make a difference for your parents or older adults from a distance?
If you live with your parents or older adults, you may not make a difference for them.
You can make difference for your parents or older adults from a distance.
Make a difference from a distance.
If you are been abused, deprived of rights, or suffer any other problem, you should report it immediately.
Eat properly, walk around properly, and maintain a proper social life.
The administration has to provide the rest of the resources.
If you can feed yourself and walk around yourself, thank God.
If a person does not eat properly, exercise properly, and maintain a proper social life properly, aging can affect him or her earlier.
If you did not get answers to your issues from this resource, you need to make clear the issues that have not been answered.
Here are further guidelines.
http://www.qureshiuniversity.com/parentsorolderadults.html
What should a medical doctor or geriatrician know about aging?
* Aging changes in the bones, muscles, and joints
* Aging changes in the breast
* Aging changes in the face
* Aging changes in hair and nails
* Aging changes in organs, tissues, and cells
* Aging changes in skin
* Aging changes in body shape
What are special health care needs of elderly persons 65 years of older?
Assistance with activities of daily living.
Lack of Resources.
Risk of victimization.
Vision deficits.
Hearing deficits.
Decrements in language comprehension and production.
Dementia.
Mobility impairment (preventing falls in the aging population).
Exercise and nutrition for seniors.
