Geriatric Assessment Strategies: Atypical Symptoms & Complex Diagnoses

Credit

Handouts/Brochure

Speaker

Susann Varano, MD Related seminars and products

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Susann Varano, MD, is a Yale University-trained physician who is double board certified in internal medicine and geriatric medicine. Her expertise is sought currently as a geriatric consultant for medically complex residents/patients and as an adjunct professor teaching geriatric coursework to physician assistant students. Additionally, Dr. Varano is the principal investigator at Clinical Research Consulting. As such, she has completed over 200 clinical trials, has presented findings at numerous national/international conferences and her written articles have been featured in US News and World Report.

Dr. Varano has served as geriatrics course director and lecturer for the Yale University School of Medicine Physician Associate Program. Additionally, she was selected to work in the Yale University Hospital Affiliated Program, a position where she would give the prestigious Medical Grand Round Lectures to medical staff as well as community physicians.

 

Speaker Disclosures:
Financial: Dr. Susann Varano is the principal clinical investigator with Clinical Research Consulting, LLC, and a geriatrician consultant with Maplewood Senior Living and Hamden Health and Candlewood Valley Rehabilitation. Dr. Varano receives a consulting fee, speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Susann Varano has no relevant non-financial relationships.

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Objectives

1. Assess the functional ability of the older adult.
2. Diagnose depression in complex older adults using validated assessment tools.
3. Determine if elder abuse is present in your patient population.
4. Apply fall assessment knowledge to improve quality of life for your patients.
5. Understand the latest covid data and how it relates to your patient population.
6. Apply long covid diagnosis and treatment knowledge to better manage your patient’s symptoms.

Outline

• Functional status
• Nutrition
• Vision
• Hearing

• History and context of a fall event
• Timed ‘get up and go’ test
• Chair stand test
• Gait and balance testing
  • Tinetti gait and balance scale
  • Observational
• Orthostatic vital signs
• Medication review
• Vision check

• History
  • Interview patient and caregiver separately
  • Begin with broad based questions
  • Be nonjudgmental with caregivers
• Physical
  • Poor hygiene
  • Dirty/torn/inappropriate clothing
  • Neglected hair/nails
• Injuries
  • Bruises to upper torso
  • Scratches/skin findings where patient cannot reach
  • Scalp injuries
• Behavior
  • Expressions of fear, avoidance of caregiver
  • Lack of eye contact with caregiver
  • Caregiver insisting on being present for all interactions
  • Serial switching of healthcare providers
  • Inconsistent history

• 3 item recall

• The Geriatric Depression Scale
• Patient Health Questionnaire-9 (PHQ-9)
• Patient Health Questionnaire-2 (PHQ-2)
  • Have you been troubled by feeling down, depressed, or hopeless?
  • have you expressed little interest or pleasure in doing things?
• Cornell Scale for Depression in Dementia

• Who is at risk
• Prevention
• Symptoms
• Testing and diagnosis, rule out similar conditions
• Current best practices for treatment

Target Audience

• Registered Nurses
• Nurse Practitioners
• Physicians
• Physician Assistants
• Physical Therapists
• Physical Therapist Assistants
• Occupational Therapists
• Occupational Therapy Assistants
• Speech Language Pathologists
• Social Workers
• Counselors
• Nursing Home Administrators