Geriatric Notes

• 1. Cognition: MMSE, minicog

  2. Visual acuity: eye chart (jaeger), <20/40 is visual impairment. 20/200 legally blind.

  3. Hearing voice: whisper after full exhalation, from a distance of 2 feet.

  4. Dental hygiene, dentures

  5. Nutritional status: wt <45 kg

     • Problems with eating and feeding

     • Malnutrition: involuntary wt. loss >4.5 kg x 6 mo; BMI <22 - >27; hypoalbuminemia <3.8 g/dL, hypocholesterolemia <160 mg/dL, vit B12 def.

     • Swallow ability

     • PEG-T/Trach

  6. Gait, ambulation: use of assist devices, speed, stability

     • Up and go timed test: get up from chair, go 3 meters turn around and come and sit back in chair in <10 sec.

  7. Foley indwelling, SPC

  8. Decubiti, skin breakdown

  9. ADLs and IADL

  10. Immunization status

  11. Sleep

  12. Incontinence

  13. Evidence of falls, h/o falls in past year

  14. Home situation

  15. NH situation

  16. Med review: polypharmacy, prescription and OTC

  17. Care givers: formal (nursing, home aide), informal (family)

  18. Assess home safety

Reversible conditions associated with Urinary incontinence (DRIIIPP):

• • Delirium

  • Restricted mobility - illnesses, injury, gait d/o, restraint

  • Infection: acute symptoms of UTI

  • Inflammation: atrophic vagnitis

  • Impaction: feces

  • Polyuria: DM, caffeine, volume overload

  • Pharmacy: diuretics, alpha-adrenergic agonists or antagonists, anticholinergics, psychotropics, antidepressants, anti-parkinsonians