Comprehensive assessment of the frail older patient

Comprehensive geriatric assessment (CGA) is a multidimensional and usually interdisciplinary diagnostic process designed to determine a frail older person’s medical conditions, mental health, functional capacity and social circumstances. The purpose is to plan and carry out a holistic plan for treatment, rehabilitation, support and long term follow up. CGA is part of an integrated approach to assessment based on the following principles:

• The older person is central to the process

• Their capacity to participate voluntarily must be assessed, and if lacking, then there needs be a system to

  address their needs in an ethical fashion.

• Links between social and health care should be good enough for older people who need comprehensive assessment to receive it in a timely and efficient manner, and proportionate to their degree of need.

• Assessments should be standardised and carried out to a reliable standard Circumstances which warrant a comprehensive assessment include, among others -

• Acute illness associated with significant change in functional ability

• Transfers of care for rehabilitation/re-enablement or continuing care

• A frail patient prior to surgery or experiencing two or more “geriatric syndromes” of falls, delirium, incontinence or immobility.