FUNCTIONAL ASSESSMENT 1FUNCTIONAL ASSESSMENT OF THE OLDER ADULT

Geriatric Education Center of Michigan

Lakshmi Gowda MD Geriatric Medicine Fellow

Hurley Medical Center / Michigan State University

Geriatric Education Center of Michigan activities are supported by a grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Public Health Service Act, Title VII, Section 753(a).

This module was developed byGeriatric Education CenterMichigan State University

LEARNING OBJECTIVES

List Quality of Life Themes for Older Adults

Define 4 Functional Domains• Cognitive• Physical• Psychological• Social

Discuss Importance of Good Fit Between:• Functional capabilities• Social support• Characteristics of environment

Discuss Altered Presentation of Illness in

Older Adults

HOW DO OLDER PEOPLE DEFINE QUALITY OF LIFE?

Think about an older person you have admired. Reflect on the good (or bad) times you’ve had with that person.

• What was important to that older person?• What did that older person value?

COMMON THEMESQUALITY OF LIFE

Home

Inde-pendence

Activity & Mobility

Spiritu-ality

Family & Friends

FUNCTIONAL DOMAINSCo

gniti

ve

Physical (gait

& ADLs)Psychological (spiritual)

Social

Support

COGNITIVE DOMAIN

Mild Cognitive Impairment

Delirium (acute confusion)

Dementia (chronic confusion)

Education

PHYSICAL DOMAIN

Gait and Balance Activities of Daily Living

• Feeding• Continence• Transferring • Toileting• Dressing• Bathing

Shopping Transportation Housework Meal Preparation

Finances Medication Telephone

INSTRUMENTAL ACTIVITIES OF DAILY LIVING

Cognitive• Delirium• Dementia• Education

Physical• ADL• Gait• Balance

Psychosocial/ Spiritual• Anxiety• Depression• Personality• Support

Burden

ENVIRONMENT

Instrumental Activities of Daily Living:

PSYCHOSOCIAL, SPIRITUAL DOMAIN

• Depression• Anxiety• Personality

Psychological

• Social Support• Caregiver Burden

Social

Spiritual

DETERMINE ‘FIT’ BETWEEN PERSON AND ENVIRONMENT

Environ-ment Cognitive Physical Psycho-

logicalSocial

Support

Functional assessment looks at fit in environment

FUNCTIONAL ASSESSMENT

Altered presentation of illness

Is it medical?

Or functional

?

Sensitive indicator

of disease

Goals of care

FUNCTIONAL ASSESSMENT: TOOLS

Consistent approach

Information for making decisions

Common language

Mechanism for re-evaluation

Monitor outcomes

Cognitive• Delirium• Dementia• Education

Physical• ADL• Gait• Balance

Psychosocial/ Spiritual• Anxiety• Depression• Personality• Support

Burden

ENVIRONMENT

Instrumental Activities of Daily Living:

QUALITY OF LIFE

Home Independence Activity & Mobility

SpiritualityFamily & Friends