Assessment task 3
“Comprehensive Assessment of Mr. Fredrick through incorporating Comprehensive Geriatric Assessment [CGA] Model”
Introduction
Ageism entails with diverse psychological, emotional, physiological and social changes that drastically impacts health outcomes of older people. The needs and preferences of aged individuals are wide and therefore, incorporation of comprehensive assessment becoming crucial in geriatric care, specifically Comprehensive Geriatric Assessment [CGA] (Kim and Rockwood, 2024). This comprehends with considering holistic domains and integrates person-centred care approach for improving patient outcomes. The present assignment complies with analysing a case study based on “Mr. Fredrick” and incorporation of CGA would be done for assuring holistic support to patient. Discussion of chosen model, pathophysiological changes, pharmacology and psychological issues comprising with CGA will be done. Moreover, importance of documentation and communication skills during comprehensive assessment would be mention.
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Main Body
1-Older Adult Profile
Mr. Fredrick [I am using a pseudonym for maintaining patient confidentiality] is a 75 years old male resides in an assisted living facility; the medical history of patient comprises with T2D, hypertension, osteoarthritis and mild cognitive impairment. Mr. Fredrick lives independently whilst; he often depends upon community support services for household tasks and transportation. He has limited social interaction and he interacts only with staff members and family members who occasionally visit him. During assessment procedure Mr Fredrick shared about mobility related complexities, particularly persisting joint pain and reducing endurance. Occasional memory loss creating difficult for him to remember certain special occasion; he is currently on certain medication- paracetamol, Metformin and lisinopril. Further, Mr. Fredrick also uses reading glass and hearing aids however; he faces issues in hearing conversation specifically in noisy environment. With some assistance; Mr. Fredrick can perform activities for daily living, particularly he needs support with household chores.
From the psychosocial context it has been evident that Mr. Fredrick has persistent feeling of loneliness and he often raised concerns regarding management of independence. The cultural background of patient inclines with preferring minimum medical intervention and respecting autonomy. Thus, this patient profile underscores the significance of integrating a person-centred care plan and multidimensional assessment for addressing cognitive, social, emotional and physical needs of Mr. Fredrick.
2-Identification and discussion of chosen assessment and model in current case context
The Comprehensive Geriatric Assessment Model [CGA] has been determined as primary model in case of Mr. Fredrick; CGA refers to multidisciplinary diagnostic and treatment process that assess individual’s psychosocial and functional limitations; this model has been proven effective in addressing physical, psychological, socio-economic domains and functional issues for developing a person-centred care plan (Salari et al, 2022). In current case context it is essential to assure significant focus on psychosocial and functional limitations faced by Mr. Fredrick. The motive of CGA complies with developing an individualized care plan that leads to improve patient quality of life and provides consistent support to them along with ensuring independence.
The suitability of CGA in case of Mr. Fredrick stemming from complex case profile as it includes chronic illness such as- cognitive impairment and social isolation. It is important to assure holistic support to patient as these complexities can create severe challenges in long-run and therefore, significant focus must be implemented on this context. CGA enables healthcare provider to incorporate diverse health domains for ensuring consistent support to patient and it supports in facilitating personalized intervention.
In Mr, Fredrick case it has been identified that CGA is positively correlated with improving clinical outcomes; this enables collaborative decision making and reduce hospital readmission rate. The collaborative decision making identified as one of the foremost aspects of CGA as this respects patient autonomy and considers their opinion. Mr. Fredrick cultural belief aligns with integration of autonomy and thereby, CGA proves to be appropriate in this context. It supports in considering the views and opinions of Mr. Fredrick within decision-making procedure and in this manner patient empowerment can be encouraged. In own practice within aged care facility integration of CGA complies with promoting holistic support and person-centred care principles which are important for supporting older individuals (Salari et al, 2021).
This specifically focuses on respecting patient’s autonomy, implementing collaborative decision making, patient empowerment and beneficence. The multidisciplinary and interdisciplinary nature of CGA plays pivotal role in promoting collaboration among healthcare providers, nurses, social workers, physicians, physiotherapist and other professionals. Hence, this leads to create consistent support for Mr. Fredrick and subsequently, comprehensive management for Mr. Fredrick can be undertaken.
In context of Current case, incorporation of CGA leads to address interconnected issues as this model acknowledge that social isolation, mild cognitive impairment and mobility issues are connected and aggregates each other. There are higher possibilities that standard assessments do not consider this interconnection and that impacts efficacy of intervention; whilst; CGA assess functional and psychosocial aspects thereby, there is no chance of missing any element. In order to implement a personalised care plan for Mr. Fredrick CGA is important as this addresses psychosocial issues and promotes holistic health evaluation through Multidisciplnary approaches. Hence, there is no doubt in depicting that CGA model is appropriate and this must be integrated for providing consistent support to Mr. Fredrick so their health outcomes could be enhanced to greater extent.
3-Identification and discussion of pathophysiological changes evident in comprehensive assessment
Normal ageing associates with diverse number of physiological alterations that impacts functional abilities and health of patient. In case of Mr. Fredrick these age-related changes were evident and this led to influence assessment procedure. Below mentioned is the detailed description related to changes evident-
Cardiovascular System
Ageing leads to reduction in cardiac output, decreases arterial compliance and increases vascular stiffness; all of these domains lead to creates mobility issues among elderly people. Mr. Fredrick has been experiencing Dyspnea on Exertion [DOE] and this is attributing in above mentioned changes. Due to DOE, Mr. Fredrick is not able to exercise as it increases breathing issues during exercise and likely to increase the risk of falls which is common in aged people (Schwartzkopf et al, 2025). This change was evident during comprehensive assessment procedure and it is important to ensure significant focus on this area so that appropriate steps can be taken for supporting MR. Fredrick.
Sensory Systems
Presbyopia and Presbycusis are common with ageing and this impairs visual ability and auditory functions; same has been evident in case of Mr. Fredrick. He has been facing difficulty in hearing; particularly in noisy environment and this is negatively impacts his communication ability during assessment (Schwartzkopf et al, 2025). His involvement is essential and hearing issue creates difficulty in implicating effective communication procedure and pessimistically impacts care discussion procedure which subsequently affects engagement and understanding level of Mr, Fredrick.
Musculoskeletal System
Osteoarthritis is characterised as most common form of arthritis; it is leading to cause joint pain in Mr. Fredrick. Hence, this is identified as main reason behind his decreasing mobility; it is increasing fall-related risks and decreasing capability of standing for long term. Thus, Mr. Fredrick persistent complaint about pain and reducing mobility found to be consistent with pathophysiological changes.
Cognitive changes
Mild cognitive impairment is recognised through decrease in memory; this is common with ageing process. Mr. Fredrick’s cognitive impairment was confirmed through integrating cognitive structured tools. Accordingly, important strategies related to decision-making capacity and safety was taken. It was important for ensuring support to Mr. Fredrick as his mild cognitive impairment can negatively impacts the care discussion procedure (Schwartzkopf et al, 2025). He might forget about the things that have been told to him and this can create negative influence on his health outcomes. The cognitive changes might lead to create negative impact on health outcomes of Mr. Fredrick and therefore, it is important to take appropriate steps; for instance- a community nurse can ensure consistent support to Mr. Fredrick and makes him aware about the steps that need to be performed.
Implication on assessment
Identifying these changes is crucial as this is important for improving assessment procedure. An effective understanding related to these changes supports in assuring accurate data collection procedure and further supports in developing appropriate interventions. For example- in case of Mr. Fredrick; effective communication mechanism needs to be integrated for addressing sensory deficit issues and undertaking mobility assessment for addressing functional limitations. Thus, these are the identified pathophysiological changes evident during CGA of Mr. Fredrick.
4-Identification and discussion of pharmacology identified during comprehensive assessment
Mr. Fredrick is on certain medication that involves Metformin for managing T2D, he takes paracetamol for joint pain and lisinopril for managing hypertensions. The pharmacokinetic and pharmacodynamic changes are common with ageism and this leads to create significant impact on medication management and same aspect has been witnessed in Mr. Fredrick case. Below mentioned is the detailed description in this context-
Pharmacokinetic Considerations
In elderly individuals decreasing hepatic function and renal influences drug metabolism and secretion; for Mr. Fredrick Lisinopril dose adjustment is essential for decreasing drastic affect comprises with hypotension (Veronese et al, 2022). Further, it is essential to undertake regular renal function tests for assessing the condition of Mr. Fredrick.
Pharmacodynamic Changes
Age-related physiological changes increases older individuals’ sensitivity towards certain medication and this can negatively impact health outcomes if appropriate focus on drug dosage has not been implemented. There are higher chances that it might affect nervous system and cardiovascular failure. Mr. Fredrick is on lisinopril and its hypotensive effect can often aggregate Mr. Fredrick condition and negatively impacts his health outcomes.
Polypharmacy Risks
Mr. Fredrick is on multiple medication and all of these medicines are specifically addressing certain issue. However, this is elevating risk related to drug interaction and further leading to create significant side effect associates with gastrointestinal disturbances, hypotension, and hypoglycaemia (Veronese et al, 2022). Furthermore, it has been evident that medication adherence might negatively impact due to sensory deficit and cognitive impairment of Mr. Fredrick. This proves that it is important to undertake consisting monitoring of medicine consumption along with ensuring specific focus on patient education.
Assessment’s Role
The CGA facilitates medication review and assessment that supports in identification of potential adverse side effects for Mr. Fredrick. Based on allocated data appropriate steps and decisions related to evidence-based pharmacological therapy can be taken. The interconnection between drugs can create severe impact on Mr. Fredrick however; CGA promotes multidisciplinary approach and therefore, physician and endocrinologist can look upon dosage requirement while analysing the condition of Mr. Fredrick and accordingly, appropriate steps can be taken. Further, nurse would be made aware about the requirement of dosage due to cognitive impairment of patient and therefore, nurse is accountable for monitoring.
5-Relevant psychosocial issues identified during your comprehensive assessment
Psychosocial factors develop persistent impact on health of elderly people and it has been witnessed from Mr. Fredrick assessment. This led to highlight significant issues comprising with social isolation, cultural preference, cognitive and functional issue and emotional issues. Mr, Fredrick is socially isolated and limited interaction contributing in feeling of loneliness. This is contributing in increasing morbidity and mortality while exacerbating the depressive symptoms. This is negatively impacting patient’s motivation in performing daily living and self-care activities (Wang et al, 2023).
On the other hand, his cultural beliefs aligns with limited medical intervention and this needs to be respected in care procedure; respecting his autonomy is highly important for encouraging collaborative decision making. This is also raising ethical concern and developing clash between patient autonomy and beneficence; in case if limited medical intervention does not work for Mr. Fredrick then this goes against principle of beneficence. In such situation, it is important to undertake a detail discussion with Mr. Fredrick and due to his cognitive impairment his primary caregiver [close family member] must be contact.
Cognitive impairments have the ability to impact Mr. Fredrick capabilities of managing health independently and therefore, integrating such care strategies which involves family member is suitable in current case. The patient expressed his concerns related to losing independence due to increasing mobility whilst; at present no symptoms related to depression and anxiety were mentioned (Wu et al, 2024).
Nevertheless, emotional support found to be important aspect in his care plan as social isolation can contribute in depressive symptoms in long run. Through integration of CGA these issues were identified and implication of care comprises with increasing social engagement of Mr Fredrick. Collaboration with social workers and health professionals in multidisciplinary teams supports in integrating a holistic approach and ensures consistent emotional support to patient (Shepperd et al, 2021). CGA comprehends with integration of multidisciplinary approach and in my role I ensured consistent focus on this area and effective collaboration with healthcare professionals supported in taking appropriate actions for Mr. Fredrick.
Understanding the physical, emotional and social needs of older adults is an important part of Aged Care Nursing Assignment Help in Australia, particularly when developing person-centred care plans.
6-Importance of documentation and communication skills during the completion of your comprehensive assessment
Comprehensive and accurate documentation of information articulates that accurate steps were taken while emphasising on patient’s safety (Zampino et al, 2022). In current assessment, I have focused on documenting important insights related to Mr. Fredrick’s medical history, cognitive status, psychosocial concerns, sensory deficit and medication management. This information was important for understanding his conditions, needs and preferences furthermore; effective communication proves to be crucial in current case context due to sensory impairment of Mr. Fredrick.
I integrated relevant strategies comprises with speaking clearly and using visual aids for improving patient understanding. I have further ensured that Mr. Fredrick is feeling comfortable and he understands all the things. His autonomy has been respected and subsequently, I provided detailed information regarding assessment and his consent was taken. I interacted with his cousin brother who was close to him and in this manner; integration of family member in care procedure was done.
The documentation of information supported in describing about the condition of Mr. Fredrick to other healthcare professionals who are in multidisciplinary team. Communication skill is crucial for implementing therapeutic alliance with patient and I was able to gain the trust of Mr. Fredrick by implementing direct communication. I ensured that conversation is taking place in calm environment so Mr. Fredrick can understand everything. Additionally, clear documentation of assessment findings ensured effective interdisciplinary collaboration and informed about care plans that facilitated monitoring. Important ethics that were considered in care procedure was involved in documentation for assuring that essential ethics were integrated in care procedure.
Conclusion
Conclusively; this can be said that CGA of Mr. Fredrick articulated about varied health complexities experienced by elderly individuals. It is important to consider age-related physiological challenges as it supports in taking appropriate assessment techniques and tailored intervention. CGA model comprises with holistic approach and significantly considers diverse complexities of patients like Mr. Fredrick and develops personalized care plan for them. From the case analysis it is evident that there is need to ensure consistent support to Mr. Fredrick by increasing his social engagement in community activities. Respectful and holistic care needs to be provided that improves his overall wellbeing.
Referencs
- Kim, D. H., & Rockwood, K. (2024). Frailty in older adults. New England Journal of Medicine, 391(6), 538-548.
- Salari, N., Darvishi, N., Ahmadipanah, M., Shohaimi, S., & Mohammadi, M. (2022). Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis. Journal of orthopaedic surgery and research, 17(1), 334.
- Salari, N., Ghasemi, H., Mohammadi, L., Behzadi, M. H., Rabieenia, E., Shohaimi, S., & Mohammadi, M. (2021). The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis. Journal of orthopaedic surgery and research, 16(1), 609.
- Schwartzkopf, A. L., Schubert, C. C., Myers, J. L., Damush, T. M., Penney, L. S., Preddie, A. K., ... & Bravata, D. M. (2025). Unique Contributions of Social Workers to Geriatric Assessments for Community-Dwelling Older Persons. Journal of Gerontological Social Work, 1-12.
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- Veronese, N., Custodero, C., Demurtas, J., Smith, L., Barbagallo, M., Maggi, S., ... & Pilotto, A. (2022). Comprehensive geriatric assessment in older people: an umbrella review of health outcomes. Age and ageing, 51(5), afac104.
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