Geriatrics


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Wellness Exam
#. Cognition: dementia, decline. > MMSE
#. Psych: depression
#. Incontinence: urinary/stool
#. Skin: pressure ulceres
#. Function: physical, social. > KATZ Index ADLs, IADLs
#. Level of care
#. Advanced Directives.
#. Quality of Life / Well-being :
#. Social Supportive / care giver
#. Socio/Economics:
#. Medical Dx/Rx Reviewed.
#. ADLs / POLST :


AP:


 
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#. Hearing handicap screening
#. Vision testing
#. Nutrition screening assessment
#. Tinnetti Balance & Gait
#. CAGE Alcoholism
#. Rx review
#. Safe driver review
#. Morse fall scale

• Beers Criteria : quick use card ; http://chpw.org/resources/Providers/Beers_Criteria.pdf
• Palliative Performance Scale :
PPS Card
• Hospice Eligibility Scale: from
UTHSCA geriatrics 
• Anticholinergic Scorecard:
Aging Brain Care PDF

• Katz ADLS & Lawton IADLS

Life Care Planning :
AZ State site : 99497
• Advanced / Pre-Hospital Medicare Care Directives :
AZ form (orange paper)
• Durable Power of Attorney :
AZ form
• Living Will :
AZ form
• AARP
Advanced Care Planning / links to all 50 states print-outs

Concern about driving?
• Drivable solutions. - insurance pays it. Test elder driving ability, makes recommendation. DMV makes decision.


Decision making: Self -> documents -> spouse -> children above 18 -> parents -> siblings -> domestic partner -> friend
Competence - legal matter, judge evaluation
Decision making capacity - medical decision, physician evaluation.


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Special Codes

99497 - used exclusively for advanced care planning.