Hi MARIO here again!

A new environment filled with strange sights, odours and sounds, a change in the daily routine, medications and tests, and the disease burden itself can all be factors that increase confusion, anxiety and agitation in a hospitalised individual with Alzheimer's disease.

When hospitalisation occurs, the best option for the individual with Alzheimer's disease is the constant presence of a family member or a trusted friend. Because this may not always be possible, I hope to serve as a guide in helping you understand and practice the many facets of care for a patient with memory disorder. I will help to meet the needs of these patients by the administration of Comprehensive Geriatric Assessment (CGA).

CGA is a clinical management strategy, used around the world, that gives a framework for the delivery of interventions which address relevant and appropriate issues related to a frail elderly individual. CGA is carried out evaluating the following domains:

1) functional status with activities of daily living (ADL index) and by instrumental activities of daily living (IADL scale),

2) cognitive status with the Short Portable Mental Status Questionnaire (SPMSQ),

3) comorbidity with the Cumulative Illness Rating Scale (CIRS),

4) nutritional status with the Mini Nutritional Assessment (MNA),

5) risk to develop pressure sores with the Exton-Smith Scale (ESS),

6) number of drugs used by patients

7) co-habitational status.

This approach determines an elderly person’s medical, psychosocial, functional, and environmental resources and problems linked with an overall plan for treatment and follow-up.

CGA has demonstrated its benefits in different areas of health and social care processes:

  • improving the diagnostic plan by appropriate selection of diagnostic tests to be performed or to be avoided;
  • giving appropriate and proportional therapeutic decisions to patient's expectations and clinical status (avoiding over or insufficient treatment), in order to reduce complications during hospitalisation (like delirium and intra-hospital infections) and lessening mortality;
  • increasing patient's functional autonomy at hospital discharge and reducing need for coming into nursing homes;
  • selection of the most adequate level of care for the patient (hospitalisation in acute or sub-acute care units, day hospital care or ambulatory care).

A favourable economic impact on costs from the above benefits is obvious and all of them have been reported at the different settings where CGA has been evaluated: ambulatory care services, hospitalisation units, and emergency services.

I hope to benefit doing the CGA in a real healthcare context, as I can potentially help better identify the needs of Alzheimer's disease patients. 

See you soon!


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