In this section : Care of the Elderly
Hospital at Home (H@H)
Stroke Care
Prescribing Advice on Admission – Medication for Parkinson’s Disease
Adults With Incapacity
Principles for Light Touch Patients – B2
Falls
Immobility
Parkinson’s Disease
Delirium
Functional & Social Assessment
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Functional & Social Assessment
Last updated 28th February 2022
This is a common non specific presenting feature of illness in older people. It is a symptom not a diagnosis.
Always Obtain a Third Party History
- Always read the GP letter.
- Talk to the relative or carer before they leave.
- Use the telephone – often the most important diagnostic tool in this context – to speak to GP, relative or carer
- Purpose is to determine whether confusion is acute, chronic or acute on chronic & over what timescale, also to perform a pre-admission functional & social assessment.
Functional & Social Assessment
- By history from relative/carer and by your own personal observations on the ward in order to compare previous and current functional status.
- There are several ways of doing this but the acronym CARDS covers most of what is required.
What To Do Next
- Physio assessment – for all elderly patients with poor mobility
- OT assessment – for all elderly patients who are muddled and/or off legs & where equipment or home visit is required
- Social work assessment – best to discuss likely social needs with relatives/carers first as SW referral unnecessary if family do not wish this form of input.
- Discuss findings and formulate discharge plan at ward multidisciplinary meeting.
Things Not To Do
- Write ‘No history available’.
- Write ‘Poor historian’ – a historian is someone who writes a history and therefore refers to yourself!