INTEGRAL GERIATRIC VALUATION

Integral Geriatric Valuation is an interdisciplinary and multidimensional structured process intended for describe, detect and clarify many physical, functional, psychology, social and settings problem affecting patient.

Objectives are:

• Detection in elderly population, those who are in critical state and needs an exhaustive specialised geriatric valuation.
• Maximize means of assistance in medical centres
• Set up a care plan
• Improve diagnostic accuracy
• Improve quality of life
• Set up a multidimensional diagnostic
• Plan the best way to apply care
• Decide the best location for the elderly patient
• Identify persons in danger
• Make sanitary resources profitable

Integral geriatric valuation uses different measures due nature of patient to make an exhaustive valuation ,it's divided in four big areas:

• Physical valuation
• Functional valuation
• Mental and social valuation
• Emotional valuation

Biological changes are not the unique changes we have to look for, there are others that we have to, this others will define patient independence.

A nurse must be able to recognise the problems that comes from cognitive, emotional, functional and social to get a global vision for evaluation.

Besides of clinic valuation (history, examination, scales), we have to keep in mind features in elderly like:

• Heterogeneous of elderly population.
• Atypical disease appearance
• Fragility
• Pluripathology and poly-pharmacy
• Homeostatic Disability, organ interaction, large diseases latency become asymptomatic, immunology disability and iatrogenic
• Less favourable prognosis due to aging
• Prognosis and therapeutic difficulties
• More sanitary resources use
• Frequently needs Social resources
• Ethic problems

Geriatric symptoms are important as this features, below I'll go in depth. 

In the functional valuation area I would highlight that to get it is necessary distinguish between basic daily activities like taking a shower, waking up,

eating and basic tools activities such use telephone, driving a car, once this concept is clear, we have to know that elderly patient could be functional

disabled, that put the limit on privacy and autonomy of the patient, that could result into paralysis.

Taking a look into mental and social area, it's important to take special care about presence of cognitive variations, that means that exists pathologies.

Physiology changes are well known and we can not attribute mental variations to elderly typical changes.

In emotional area, depression detection, anxiety and lonesomeness are important to evaluate, elderly situations such retirement and other can result in it.

   

I have to mean with this brief post that we must go in depth on each valuation, we have to keep in mind elderly diseases properties, geriatric symptoms, medical valuations and the relationship between all of them to know and get a good integral geriatric valuation. 

Consulted bibliography :

Hoffman. G. Basic geriatric nursing. 5^th edition. Ed. Elsevier. 2012 St. Louis, Missouri Valero, C.; Regalado, P J; González Montalvo, J I; Alarcón Alarcón, M T; Salgado, A.