Age Related Debility-884

ReidHealthCDI

Hi,

Does anyone have any parameters they have their CDI team use when capturing age related debility other than age, PT/OT need? I am hoping to develop a decision tree for my team.

Thanks!

deanne.wilk@hcpro.com

Hi ReidHealthCDI,

Below is some information that I have on this if you find it useful.

Deanne Wilk

Assessment of Age-Related Debility

1. Initial Assessment

• Step 1: Patient History
  • Assess medical history, including chronic diseases, medications, and previous hospitalizations.
  • Evaluate psychosocial factors, such as living situation, social support, and mental health.
• Step 2: Physical Examination
  • Perform a general physical examination to check for signs of malnutrition, dehydration, or other physical conditions.
  • Assess vital signs: blood pressure, heart rate, respiratory rate, and temperature.

2. Functional Assessment

• Step 3: Activities of Daily Living (ADLs)
  • Assess the ability to perform basic ADLs: bathing, dressing, toileting, transferring, continence, and feeding.
  • Use standardized tools like the Katz Index of Independence in Activities of Daily Living.
• Step 4: Instrumental Activities of Daily Living (IADLs)
  • Assess more complex activities: using the telephone, shopping, preparing food, housekeeping, laundry, transportation, taking medications, and managing finances.
  • Use tools like the Lawton IADL scale.

3. Cognitive Assessment

• Step 5: Cognitive Screening
  • Conduct a cognitive screening using tools like the Mini-Mental State Examination (MMSE).
  • Evaluate for signs of dementia, delirium, or mild cognitive impairment.

4. Nutritional Assessment

• Step 6: Nutritional Status
  • Evaluate dietary intake and weight history.
  • Use tools like the Mini Nutritional Assessment (MNA) to assess for malnutrition.

5. Physical Performance and Mobility

• Step 7: Mobility and Balance
  • Assess gait and balance using tools like the Timed Up and Go (TUG) test.
  • Evaluate muscle strength and endurance using tools like the Short Physical Performance Battery (SPPB).

6. Mental Health Assessment

• Step 8: Depression and Anxiety Screening
  • Screen for depression and anxiety using tools like the Geriatric Depression Scale (GDS) or the Patient Health Questionnaire-9 (PHQ-9).

7. Comprehensive Geriatric Assessment (CGA)

• Step 9: Comprehensive Geriatric Assessment
  • Integrate findings from all assessments to develop a holistic view of the patient’s health status.
  • Consider involvement of a multidisciplinary team, including physicians, nurses, social workers, nutritionists, and physical/occupational therapists.

8. Diagnosis and Care Planning

• Step 10: Diagnosis
  • Based on the assessment data, diagnose age-related debility if multiple domains show significant decline.
  • Rule out other causes of debility, such as acute illnesses, reversible conditions, or medication side effects.
• Step 11: Care Plan Development
  • Develop a personalized care plan addressing identified needs and goals.
  • Include interventions such as physical therapy, nutritional support, social services, and mental health support.
  • Establish follow-up and reassessment intervals to monitor progress and adjust the care plan as needed.