Evaluation plan
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My evaluation plan includes a full comprehensive assessment of this patient for his annual physical examination. This will include reviewing PMH, medications, allergies, functional status, areas of concern, a full head to toe assessment, obtaining objective and subjective data and education. The Comprehensive Geriatric Assessment (CGA) tool kit is utilized around the world for best practice when caring for the geriatric population. This tool is a highly detailed guide to geriatric wellbeing. The British Geriatric Society outlines this well noting that is encompasses assessment of physical, socioeconomic, environmental, functional, mobility and balance, psychological wellbeing and medication review (British Geriatrics Society, n.d.). Under these general assessment umbrellas are guidelines for specific evaluations of all aspects of the patient and reviews age related considerations for geriatric assessment. This assessment tool is used globally and is supported by the National Center for Interprofessional Practice and Education. In addition to a full assessment, I would perform a focused assessment on his left knee. The Osteoarthritis Action Allegiance (OAA) suggests a few performance-based assessments that can provide data of disease progression. These include the 30 second chair stand test, 40 meter fast paced walk and the stair climb test (Osteoarthritis Action Allegiance [OAA], 2022). Decline in ability to perform these tasks can indicate worsening disease in combination with joint swelling and pain. During these assessments, it is important to keep in mind age related considerations that may cause issues in the assessment. These can include a patient being hard of hearing, language barriers, acuity if ill and education barriers. Fortunately, there are tools for practitioners to utilize to ensure the patient fully understands their care plan such as interpreters, handouts with plain language and nurse educators. In addition, encouraging a caretaker to be present during education or functional exams may be comforting to the patient and allow for better comprehension.
This patient also asked for his annual flu shot, which would be appropriate. The CDC recommends patients over the age of 75 also receive a COVID-19 booster, a pneumococcal vaccination and RSV vaccination (Center for Disease Control and Research [CDC], n.d.). These vaccines can prevent the patient from getting life threating lung infections that could require hospitalization or even death.
References
Centers for Disease Control and Prevention. (n.d.-a). Adult immunization schedule notes. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/hcp/imz-schedules/adult-notes.html#note-pneumoLinks to an external site.
Comprehensive geriatric assessment toolkit for primary care practitioners. British Geriatrics Society. (n.d.). https://www.bgs.org.uk/resources/resource-series/comprehensive-geriatric-assessment-toolkit-for-primary-care-practitionersLinks to an external site.
Functional assessments in osteoarthritis care. (n.d.). https://oaaction.unc.edu/wp-content/uploads/sites/623/2022/01/21.-PPT-Functional-Assessments-in-Osteoarthritis-Care-v6.pdfLinks to an external site.
Grazioli, A. (2023, June 12). CGA Toolkit Plus: Resources for the Comprehensive Geriatric Assessment based proactive and personalized primary care of the elderly. National Center for Interprofessional Practice and Education. https://nexusipe.org/informing/resource-center/cga-toolkit-plus-resources-comprehensive-geriatric-assessment-basedLinks to an external site.
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