Comprehensive Geriatric Assessment Essay Example for Free

Comprehensive Geriatric Assessment Essay The geriatric assessment is a multidimensional, multidisciplinary diagnostic instrument designed to collect data on the medical, psychosocial and functional capabilities and limitations of elderly patients. Various geriatric practitioners use the information generated to develop treatment and long-term follow-up plans, arrange for primary care and rehabilitative services, organize and facilitate the intricate process of case management, determine long-term care requirements and optimal placement, and make the best use of health care resources. The geriatric assessment differs from a standard medical evaluation in three general ways: (1) it focuses on elderly individuals with complex problems, (2) it emphasizes functional status and quality of life, and (3) it frequently takes advantage of an interdisciplinary team of providers. Whereas the standard medical evaluation works reasonably well in most other populations, it tends to miss some of the most prevalent problems faced by the elder patient. These challenges, often referred to as the Five Is of Geriatrics, include intellectual impairment, immobility, instability, incontinence and iatrogenic disorders. The geriatric assessment effectively addresses these and many other areas of geriatric care that are crucial to the successful treatment and prevention of disease and disability in older people. Performing a comprehensive assessment is an ambitious undertaking. Below is a list of the areas geriatric providers may choose to assess: †¢ Current symptoms and illnesses and their functional impact. †¢ Current medications, their indications and effects. †¢ Relevant past illnesses. †¢ Recent and impending life changes. †¢ Objective measure of overall personal and social functionality. †¢ Current and future living environment and its appropriateness to function and prognosis. †¢ Family situation and availability. †¢ Current caregiver network including its deficiencies and potential. †¢ Objective measure of cognitive status. †¢ Objective assessment of mobility and balance. †¢ Rehabilitative status and prognosis if ill or disabled. †¢ Current emotional health and substance abuse. †¢ Nutritional status and needs. †¢ Disease risk factors, screening status, and health promotion activities. †¢ Services required and received. The primary care physician or community health worker usually initiates an assessment when he or she detects a potential problem. Like any effective medical evaluation, the geriatric assessment needs to be sufficiently flexible in scope and adaptable in content to serve a wide range of patients. A complete geriatric assessment, performed by multiple personnel over many encounters, is best suited for elders with multiple medical problems and significant functional limitations. Ideally, under these circumstances, an interdisciplinary team representing medicine, psychiatry, social work, nutrition, physical and occupational therapy and others performs a detailed assessment, analyzes the information, devises an intervention strategy, initiates treatment, and follows-up on the patients progress. Due to the intricate nature of comprehensive assessments, many teams designate a case-manager or caseworker to coordinate the entire effort. Most assessments take place in medical offices and inpatient units over multiple visits. If at all possible, however, at least one member of the team (rarely the physician) will attempt to visit the patient at home. Despite the problem of low or no reimbursement, the typically high-yield of information from even a single home visit makes it an extremely efficient use of resources. Most geriatric assessments, performed under the constraints of time and money, tend to be less comprehensive and more directed. Although such modifications are best suited to relatively high-functioning elders living in the community, many practitioners find some version of a directed geriatric assessment to be a more realistic tool in a busy practice. Patient-driven assessment instruments are also popular among geriatricians. Asking patients to complete questionnaires and perform specific tasks not  only saves time, but also it provides useful insight into their motivation and cognitive ability. To the extent that patients are unable to complete the assessment themselves, practitioners resort to traditional patient interview techniques that frequently involve input from a family member or other caregiver. During your upcoming site visits, you will perform a directed geriatric assessment (DGA), ideally with the same patient, over two sessions. In the interest of education, most of your DGA instruments are student-driven, rather than patient-driven, and require relatively little information from caregivers who may or may not be available at the time of your visit. We have divided the DGA in two parts, each with three subsections. In Part I, you will perform an expanded medical interview covering the clinical history, nutritional assessment and a social evaluation. In Part II, you will perform neuropsychiatric, physical and functional examinations. What follows is a reproduction of the History and Physical (HP) format that you will use in your Physical Diagnosis II course next semester. Although all geriatric practitioners do not use a standard assessment format (comprehensive or otherwise), most agree on basic content. The comprehensive geriatric assessment (history examination) following the Physical Diagnosis outline covers the most significant content areas of a prototypical geriatric assessment. As you can see, it moves well beyond the standard HP, which is precisely the point. We have designed it to correlate as closely as possible with the history and physical you will be learning later this year. It is to your considerable advantage to review this information before meeting your patients face-to-face on the site visits. The DGA instrument you will use during your encounter immediately follows this section.

Should Workers Be Allowed To Strike? - Argumentative Essay

It is difficult to see how anyone could deny that all workers should have the rights to strike. This is because striking gives workers freedom of speech. This is justifiable, because Britain is a democratic nation. My first reason supporting the motion that workers should be allowed to strike is in order to bring to the fore poor safety conditions. For instance, in the nuclear power industry, any breaches of safety can have tragic consequences. If the employees are exposed to nuclear material, this could lead to serious illnesses such as cancer, leukaemia and radiation sickness. Radioactive material could also affect residents of the surrounding area, as in the case of the Chernobyl disaster. In the light of poor safety conditions, workers striking can be justified by the fact that the government and public would be informed. Similarly, another justification for employees striking is that production and confidence would perhaps increase after industrial action. This could be because, when workers strike for higher pay or better conditions and their employers meet their demands, the employees return to their place of work with higher morale than before the walk-out. As a consequence, the higher productivity would be beneficial to the owners. Likewise, industrial action gives the worker a line of protest against unfair hours or miserly wages. Theoretically, if taking industrial action was outlawed, the management could impose any terms and contract changes that they wished ...

Swimming: An Important Life Skill

An Important Life Skill Swimming is a very important and necessary life skill to have; for this reason it should be included in part of the wellness curriculum at Negotiation High School. If a person has the proper knowledge of life saving skills/techniques, he or she will be able to save his or her own life as well as other people. Swimming is also an abundant way of exercise. Lastly, it is a pleasurable activity. Did you know that 3,400 people drown in the US per year? Imagine being one of those people.Even if it may not be fast, competitive swimming, basic skills are necessary for survival. If you have the ability to be resourceful and can float for a couple minutes you have the power to save your own life. Lifesaving is another crucial skill to have. When someone is close to drowning, he or she might only have a few moments to live. Within those moments, if a person who has been trained in lifesaving skills, he or she would be able to save the drowning victim. When doing so it is important not to make physical contact with the victim or else he or she might take the rescuer down with him or her.The swimming unit in wellness teaches us how to do so. It also instructs us on the cautions one should take while saving an unconscious victim so it does not result in the victim's neck snapping. Swimming is also a great way of exercise. It does not wear out the Joints so people can use this as a method of exercise even when they become elderly. It is an excellent way to stay in decent physical condition throughout the years. With other sports, people tend to have to give up playing since it often results in Joints starting to ache and wear down. This leads to people having to get urge.With swimming, this is a factor that people are not concerned with since joints are never strained. It can also be a pleasurable activity. If your friends all decided to go to the beach and you were the only one who did not know how to swim, most likely, you would not end up having a g reat time. Learning Just the basic skills of swimming can prevent you from having a bad time at the beach, for instance. There are many sports you can play in the water if competitive swimming is not an enjoyable activity in your opinion. This list of sports include: water polo, volleyball,Frisbee, etc. It can be inferred that swimming is a very imperative skill to know. It can be used to save another person's life or your own life with a few simple techniques and strokes. Swimming, correspondingly, is an amazing way to exercise and stay in shape through the course of a lifetime since it does not wear out Joints like most other sports do. In conclusion, it is also a great leisure activity. These are Just a few of the ample amount of reasons why swimming is a very important course and should be part of the wellness curriculum at Negotiation High School. By Mauritania

Persuasive Speech Outline For Non Rising Of Minimum Wage...

Jessica Raya Speech 100 Professor Blumer 11/10/16 Persuasive Speech Outline __________________________________________________________________________ General purpose: The general purpose of this speech is to persuade the audience. Specific purpose: The specific purpose of my speech is to persuade my audience to support the non-rising of minimum wage. ___________________________________________________________________________ Introduction Attention getter (teaser): How many of you believe we in the state of California should have a higher minimum wage? Well we shouldn’t and I’m going to tell you why. Significance (why important to them?): A lot of people believe that because you re getting paid a higher minimum wage that it’s benefiting you but in reality that’s not the case. The purpose of my speech is to persuade you to support the non-rising of minimum wage. Central idea/thesis Preview of main points: The minimum wage policy in California should not increase, but first, let me inform you of the effects of increasing the minimum wage, next, let me explain the causes, and finally, let me offer several solutions to solve these issues. Body I. First main point: First, let me inform you on the effects of increasing the minimum wage. The minimum wage is the lowest wage that is permitted by law or by special agreement. A. Subpoint: One of the main effects of increasing the minimum wage is that it would result in job loss. Support: While raising minimum wageShow MoreRelatedThe Evolution Of China s Labor Market System3965 Words   |  16 Pageson China. Identify differences in the legal roles, responsibilities, and perceptions of labor unions in both countries. Present research data describing union membership trends in the United States. Outline the collective bargaining process and its advantages to workers. Compare and contrast wages and working conditions in both countries. Discuss the development of major labor laws that correlate with equality in the workplace. Compare and contrast grievance systems and discuss due process. ExploreRead MoreChern12534 Words   |  51 Pages†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..†¦.. 21 Table - Projections Michigan †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦ 22 Table - Wages amp; Employment Trends - National †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 22 Table - State and National Trends †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 23 Recruiting †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. Employer Image Diversity Recruiting Guide Outline Prioritization of Recruiting Sources †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. Prioritization of Staffing outcome†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Read MoreOne Significant Change That Has Occurred in the World Between 1900 and 2005. Explain the Impact This Change Has Made on Our Lives and Why It Is an Important Change.163893 Words   |  656 Pagesservice both far and near. But the explosion in quantity was also a transformation in quality. Migrations were inseparable from unprecedented urbanization and population growth, the expansion of industrial production and global markets, the spread of wage labor, the growth and extraction of food and resources to feed those workers, the revolution of transportation technologies, and the accompanying creation of an international system of nation states, borders, and population management techniquesRead MoreOrganisational Theory230255 Words   |  922 Pagesbe understood, that organization theory is not a monolithic subject but rather a rich resource for developing understanding of organizations. Each chapter begins with an Introduction which outlines the content and direction of the chapter, provides a clear guide to the structure of the chapter and then outlines the Learning outcomes. These learning outcomes provide a guide to the different sections of the chapter. Stop and think Each of the chapters contains ‘stop and think’ boxes. These are designedRead MoreMarketing Mistakes and Successes175322 Words   |  702 Pagesa book that can help transform dry and rather remote concepts into practical reality, and lead to lively class discussions, and even debates. In the gentle environment of the classroom, students can hone their analytical skills and also their persuasive skills—not selling products but selling their ideas—and defend them against critical scrutiny. This is great practice for the arena of business to come. NEW TO THIS EDITION In contrast to the early editions, which examined only notable mistakesRead More65 Successful Harvard Business School Application Essays 2nd Edition 147256 Words   |  190 Pagescampuss top new television reporter, and as a junior and senior, I translated that passion for human connection into a stint as Berrys top newspaper opinion columnist and a widely read campus poet. I was the lead in a one...act play and led my college speech team to its highest ever national finish. I learned business, finance, and organi... zationalleadership by founding a community soup kitchen andlead... ing the campus investment group to unprecedented stock market returns; and in everything, I soughtRead MoreLibrary Management204752 Words   |  820 Pagesâ€Å"Management Education for Archivists, Information Managers and Librarians: Is There a Global Core?† Education for Information 2 (December 1984): 295–307. 11. Thomas Wolf and Barbara Carter, Managing a Non-Profit Organization in the 21st Century (New York: Fireside, 1999), 19. 12. Peter Drucker, Managing the Non-Profit Organization: Principles and Practices (New York: Harper Collins, 1990). 13. Information about Drucker’s self-assessment for nonprofits and much other useful information about managing inRead MoreDeveloping Management Skills404131 Words   |  1617 Pagesdegree of success or failure. In summary, evidence suggests that a five-step learning model is most effective for helping individuals develop management skills (see Cameron Whetten, 1984; Kolb, 1984; Vance, 1993; Whetten Cameron, 1983). Table 3 outlines such a model. Step 1 involves the assessment of current levels of skill competency and knowledge of the behavioral principles. Step 2 consists of the presentation of validated, scientifically based principles and guidelines for effective skill performanceRead MoreStrategic Human Resource Management View.Pdf Uploaded Successfully133347 Words   |  534 Pagesinvestments in employees by p aying a wage during Page 9 STRATEGIC HUMAN RESOURCE MANAGEMENT Section One training, which has been reduced by the training costs. Employers also can recoup some of their investments in general training because employees incur costs of mobility, such as the costs of finding new jobs and relocating. If the costs of mobility are high enough (moving expenses, realtors’ fees, psychological costs of moving children, etc.) the employer can pay a wage lower than the employee’sRead MoreStrategic Marketing Management337596 Words   |  1351 Pages 12.17 Integrating the elements of the marketing mix 12.18 Summary Stage Four: Which way is best? Strategic evaluation 13 Criteria of choice 13.1 Learning objectives 13.2 Introduction 13.3 Financial versus non-financial criteria; effectiveness versus efficiency 13.4 Financial criteria 13.5 Non-financial criteria 13.6 Multiple criteria 13.7 Summary 14 Modelling approaches – 1 14.1 Learning objectives 14.2 Introduction 14.3 Cost–volume–profit analysis 14.4 Investment appraisal 14.5 Summary 15 Modelling