Biomedical Engineering Reference
In-Depth Information
TABLe 13.2 (COnTInUeD)
Geriatric Assessment of a Clinical Case
GA
Components
ICF codes
A.B.
Functional
BF:b176.0, b525.0, b620.0
AP: d177.1, d230.1,
d360.0, d410.0, d440.0,
d450.0-d460.0, d475.9,
d510.1, d520.0, d530.0,
d540.0, d550.0, d560.0,
d620.1, d630.1, d640.1
EF:e110.2, e165.0
Assistance with bathing for fear of falling;
puts on clothes and dresses without any
assistance, except for tying shoe laces. goes
to toilet room, uses toilet, arranges clothes,
and returns without any assistance (may use
cane or walker for support and may use
bedpan/urinal at night; moves in and out of
bed and chair without assistance (may use
cane or walker); controls bowel and bladder
completely by herself; feeds herself without
assistance; dials a few well-known numbers;
shops independently for small purchases;
prepares adequate meals if supplied with
ingredients; performs light daily tasks such
as dishwashing, bed making; launders small
items; rinses stockings, etc.; travel limited to
taxi or automobile with the assistance of
another; is not capable of dispensing own
medication; manages day-to-day purchases,
but needs help with banking, major
purchases, etc.
Environmental
AP: d475.9
EF: e110.0, e340+2,
e355+1
Services within walking distance; Geriatric
Assessment every six months; No car
Social
Support
EF: e310+3, e320+2,
e340+2, e355+1, e360+0,
e410+3, e440+0
Familiar people are a valid support but they
are committed for the greater part of the day;
family and friends presence reduces
depressive and apathetic symptoms.
Economic
AP: d870
EF: e165
No economic problems
Spirituality
AP: d930.2
EF: e465+3
Before the disease she had a rich social
network linked to a parochial centre
Advance Dir
ectives
EF: e360+0
The patient refuses a non-familiar caregiver
The Geriatric assessment procedure, conducted using the instruments indicated in Table 13.1, explores nine
domains: medical, cognitive, affective, functional, environmental, social support, economic, spiritual, and advance
directives (first column). The domains include several components reported in the second column. The third col-
umn shows ICF codes for body structures (BS), body functions (BF), activities and participation (AP), and environ-
mental factors (EF) related to A.B. geriatric assessment. In the fourth column, the condition of Mrs. A.B. is described.
The hypothetical future scenario configures a progressive worsening of cognitive deficit
because of the progression of Alzheimer's disease. The possibility of her becoming lost
when away from her home must be carefully considered because of her orientation deficits.
At the same time, the possibility of walking to the parochial center or to the grocery store
represents an opportunity for activity and participation to be maintained. Living in a
small town represents an advantage in this sense. On the basis of the literature, Mrs. A.B.
will lose her abilities in the ADLs, and difficulties with self-care and domestic life will
manifest. If not stimulated by means of social and mental activities, Mrs. A.B. will suffer
a worsening of apathetic and depressive symptoms with a reduction in participation. The
assumptions of rivastigmine therapy include paying particular attention to the potential
