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PubMed2004

Taking the next steps in goal ascertainment: a prospective study of patient, team, and family perspectives using a comprehensive standardized menu in a geriatric assessment and treatment unit.

OBJECTIVES: To examine the performance of an expanded menu of goals in a geriatric rehabilitation setting incorporating patient, family, and team perspectives. DESIGN: Prospective comparative study. SETTING: Inpatient geriatric rehabilitation unit. PARTICIPANTS: Nineteen consecutive eligible inpatients and their family members and seven unit team members. MEASUREMENTS: Each participant independently reviewed a standardized menu of medical, functional, psychosocial, spiritual, and future planning goals, which were compared with the goals set by the healthcare team. RESULTS: On average, patients and their family members agreed on goals about half the time; family members tended to have more goals than patients. Agreement between the team and patients and families was poor (kappas=-0.11-0.33). The team was less likely to identify functional, psychosocial, spiritual, and future planning goals. CONCLUSION: Patients and families have a broad range of goals that are not always identified by the healthcare team. A comprehensive standardized menu is feasible and may be helpful in setting goals in a geriatric rehabilitation setting.

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PubMed1996

[Pilot experience with the use of an ambulatory geriatric assessment instrument].

BACKGROUND: Ten percent of the Chilean population is over 60 years old and general practitioners need an instrument to assess the degree of disability and multiple ailments of elders. AIM: To develop and use an instrument to assess elders consulting in primary care outpatient clinics. PATIENTS AND METHODS: An instrument to be used by general practitioners, aimed to assess bio-psico-social risk of elders was devised by the Geriatrics Program at the Faculty of Medicine of the Catholic University of Chile. The instrument was used in 100 elders (82 female) aged 71 +/- 8 years old consulting in a primary care outpatient clinic. RESULTS: The instrument took less than 5 minutes to be used. The most frequent risk factors found were living alone in 62% of subjects, falls in the last year in 47%, memory disturbances in 62%, overweight in 76%, visual impairment in 76%, urinary incontinence in 26% and depression in 76%. Thirty percent had difficulties to climb stairs and 4% had no support in case of severe disability. CONCLUSIONS: The applied instrument is fast to apply, easily understood by patients and detects problems associated with old age, that will help to plan primary care health programs.

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PubMed2000

[A multidimensional questionnaire as a component of preventive geriatric assessment: comparison of self-assessment version with the interview version].

In an earlier study we have shown good internal consistency and test-retest-reliability of a newly developed German-language instrument in the interviewer-administered version. The aim of this study was to test the reliability of a self-administered version compared to the original interviewer-administered version of our newly developed German-language instrument. We recruited a group of 50 over 75-year-old community-dwelling persons in Hamburg, Germany (N = 25) and Berne, Switzerland (N = 25). The questionnaire contains items on: self-perceived health, chronic conditions, basic and instrumental activities of daily living, urinary incontinence, nutrition, recent falls, pain, the social support/network and preventive-care measures. In addition, the Functional Status Questionnaire, the Physical Activity Scale for the Elderly, the Geriatric Oral Health Assessment Index, the Visual Function Questionnaire, the Hearing Handicap Inventory for the Elderly and the Geriatric Depression Scale were administered. Cohen's Kappa (self-administered version compared to the interviewer-administered version) was good to excellent (0.69-1.0) with only three exceptions (physical activity kappa = 0.49, basic activities kappa = 0.54 and oral health kappa = 0.54). For the domains activities of daily living, oral health, visual function and depression the self-administered version detected significantly more problems than the interview. In the future the self-administered version of this assessment instrument can be used for various purposes, e.g. (annual) preventive geriatric assessment for outpatients and other community-dwelling persons and epidemiological studies in older persons.

Activities of Daily Living↗