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Geriatric Assessment
DON’T BELITTLE THAT ANNUAL GERIATRIC ASSESSMENT YET!
A couple of years ago I wrote that nothing can be more disconcerting for seniors than a cold, hard look at a “functional assessment” of one’s activities of daily living and one’s instrumental activities of daily living, which activities we have taken for granted over a lifetime. The “assessment” can bring a sense of dread, embarrassment, and, at times, an awful feeling of helplessness, and, of course, our tendency as we age is to dismiss any “assessment” which shows a decline in our “functional abilities”. We simply believe that it cannot or will not happen to us, or that given time, we can correct it.
In our Resident Handbook and Assisted Living Handbook, we note that the initial and annual assessments are not “tests” but rather a positive program that enables an Arcadian to identify personal needs and the manner in which Arcadia may address ways to meet those needs. These assessments and discussions also help the Arcadian’s family, the Arcadian’s physician and the Arcadia staff to make informed judgments about what assistance or care is or may be needed.
Yet, I know, that no matter how you approach this “assessment”, your assessment is still a specific look at you – up close and personal – and that it can be discombobulating and personally invasive.
In a month and a half snapshot in early 2004 that included personal assessments and diminished health for me, I learned first hand how a caring team of specialists, a very caring family and caring friends can make the assessment process understandable and a viable tool for all of us. I also learned that you need to adjust your thinking and efforts if you are to achieve a reasonable quality of life. Allow me to share with you a brief look at the components of the geriatric functional assessment that enables an Arcadian and our staff to get together on the same sheet of music for one’s personal health, personal care, and best interests.
With due respect to the clinicians and the harsh reality of cold hard factual reports, as you “age in place “ what you are doing on a daily basis as a senior is viewed through the following lenses:
• What are you doing in the community;
• What are you doing with your family and friends;
• What activities, including recreational pursuits, are you doing;
• How are you doing with your activities of daily living (that is, eating, toileting, ambulating, dressing and bathing);
• How are you doing with writing checks and balancing your accounts, doing the laundry, dining, keeping track of your bills, taking care of your medications and doctor appointments and the myriad other matters that fill each of our days!
As we age and become less healthy and sharp, we slack off in many of these above mentioned tasks.
Recognition by others of a “slack off” and a diminishment in our daily routines is, perhaps, the most difficult “evaluation” to accept. But, you must accept this initial recognition and “preliminary evaluation” by others because the next steps – with a loving and caring family, good friends and well informed professionals – will help you make adjustments and enable you to continue to be a viable part of your community in your own little corner of the world.
As we age in place at Arcadia, we talk about one’s status, concerns and needs in seven important areas involving you, your family and Arcadia’s staff:
• Cognitive
• Medical
• Affective
• Social Support
• Spiritual
• Economic
• Environmental
It is important to remember that your increased needs in certain areas do not mean that change is required – it means that adjustments may be needed to improve your daily quality of life.
Cognitive means that we talk about your memory and how best we can help you recall and assist you with the things you have been doing all your life.Medical means that we talk about your medical history, your medications, nutrition, hearing, vision and incontinence problems, and about your mobility and risk of falling.
Medical means that we talk about your medical history, your medications, nutrition, hearing, vision and incontinence problems, and about your mobility and risk of falling.
Affective means that we talk about your feelings and whether you are sad, depressed, happy, or just “regular”.
Social Support means that we talk about your family and friends and the love and assistance they provide. Do they, for example, help with any of your activities of daily living? Do they, for example, help with check writing, dining, laundry, medication management? Do you have an Advance Directive (a living will)? Does anyone hold a general power of attorney for you?
Spiritual means that we talk about the importance of religion, spirituality and pastoral care with you. It’s interesting and helpful to share with each other the wonders of our sense of belonging, our meaning to each other and our meaning to the one who created us. At Arcadia, there are no limits to what the great religions of the world teach us or what one’s agnosticism or atheism means. At Arcadia, all are accepted and become a part of the Arcadia family as aging in place occurs.
Economic means that we talk about your financial health and resources and how any additional care you may desire or need can be provided. And remember, the minute you moved into Arcadia, you became an Arcadian for the rest of your days on earth, no matter your unintentional financial status or plight.
Environmental means that we talk about the safety of your apartment environment and what can be done to make your apartment safer and what medical and personal services would be specifically helpful to you in your apartment to maintain the quality of your daily living routine.
I hope this brief synopsis of what Arcadia, your family and your friends do after taking a peak through the “lenses” mentioned earlier brings a bit of comfort and knowledge to you.
You know, during your youth, your parents (and other siblings) and grandparents acted as your guide and showed you what you should be seeing through the lenses. Then, for many, many years you taught others what was to be seen and expected to be seen through the lenses. Now, as you have aged in place, you need to join forces with those who care about you to adjust and “de-fog” those lenses that you have used for so many years. It’s just the way it’s supposed to be – thanks for listening.