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