Visit 1
General Assessment of Patient
Objectives:
- Demonstrate interprofessional professionalism in interacting with assigned patient and team.
- Re-establish rapport with the team and establish rapport with assigned patient.
- Take a health history including chronic diseases and family history.
- Take patient's vital signs; get list of medications.
- Identify/describe patient's current wellness strategies (nutrition, exercise, safety practices, etc.).
- Assess patient's access to needed acute, chronic, and/or preventive care (financial, transportation, language barriers, etc.).
- Assess patient's level of independence--frailty, muscle strength, nutrition, advance planning and fall risk).
- Introduce home safety checklist; ask patient to complete for Visit 2.
- In Google Drive, prepare report for Visit 1 review session and complete reflection prompts.
- Prepare for Visit 2.
Activities:
- Review materials and guide; work with team to prepare for Visit 1.
- Complete Visit 1 with elder.
- As a team, prepare a patient presentation report for the review session.
- Locate community resources appropriate to meeting the patient's needs.
- Be prepared to share what you found with your patient at Visit 2.
Guide for Visit 1:
- Introduce your team, role and purpose.
- Ask about past medical history.
- Ask about current medications and the reason they're prescribed.
- Assess patient's vital signs, heart and lung sounds, distal pulses, etc. Record.
- Ask patient what they do to stay healthy (nutrition, exercise, safety, etc.). Reinforce healthy behaviors.
- Ask about patient's use of community resources, including possible resources the patient needs, but has not located.
- With your patient, assess his/her:
- RGA--Rapid Geriatric Assessment -- Use the sub-scales to assess Frailty, Muscle Strength, Nutrition, and Advance Planning (omit the RGA Rapid Cognitive Screen for now)
- Falls Risk Assessment - Use CDC Stay Independent Checklist
- Explain Home Safety Checklist. Ask patient to complete in preparation for Visit 2.
- FOLLOW UP the 3 RGA sub-scales as appropriate using
- Nutrition - Use nutrition screen
- Level of Independence - Use Katz ADL or Lawton-Brody IADL tool as appropriate
- Health Literacy - Use 3 Question Screen to assess patient's comfort level with printed medical information. Follow up with Newest Vital Sign tool as appropriate
- Close this visit with an overview of next visit.
Tools:
- RGA: Rapid Geriatric Assessment (Two-ply self-copying form to be distributed at orientation; video review available at https://www.youtube.com/watch?v=z79-UQvTOXs&t=139s )
- CDC Stay Independent Checklist
- Home Safety Checklist (BrightStar)
- Nutrition Screen
- Katz Activities of Daily Living or Lawton Brody Independent Activities of Daily Living as appropriate
- Health Literacy - 3 Question Screen and/or Newest Vital Sign Tool as appropriate
- Advance planning guide booklet