The Comprehensive Geriatric Assessment (CGA)
The Comprehensive Geriatric Assessment (CGA) is a multidimensional, multidisciplinary diagnostic process used to determine medical, functional, and psychosocial problems and capabilities in an elderly patient who may be at risk for functional decline.
The Comprehensive Geriatric Assessment (CGA) is designed to:
Evaluate the multiple problems of older persons
Assess their personal resources and strengths
Determine service needs
Develop coordinated care plans to focus interventions on individual problems
What Does the CGA Evaluate?
The medical history focuses special attention on medication use and the risk for malnutrition, falling, incontinence, and immobility.
The physical examination seeks to identify specific diseases or conditions for which curative, restorative, palliative, or preventive treatment may be available. Special attention is directed toward visual or hearing impairment, nutritional status, and conditions that may contribute to frailty and falling or difficulty in ambulation.
Cognitive, behavioral, and emotional statuses are evaluated, with particular emphasis on detecting dementia, delirium, and depression.
The social support network includes the availability and competence of caregivers, the elderly person’s economic resources, and other sources of support such as cultural, ethnic, and spiritual resources. It also includes the individual's own assessment of the quality of life.
Functional status is measured by the ability to accomplish basic activities of daily living (ADLs) and to participate in behavioral and social activities referred to as instrumental activities of daily living (IADLs). ADLs include bathing, dressing, toileting, transferring, continence, and feeding. IADLs require a higher level of cognition and judgment than physical activities and include preparation of meals, shopping, light housework, financial management, medication management, use of transportation, and use of the telephone.
Evaluating the patient's physical environment determines the safety of the living environment. It also assesses the patient’s access to essential services, such as shopping, pharmacy, and transportation.