Healthcare Providers – OAC Toolkit Items: Clinical Assessment of Older Adults
Resources specifically culminated for physicians, trainees, nurses, social workers, and other healthcare professionals
New Resource
Free CME module series for providers: Caring for Older Adults During COVID-19: Assessment and Management via Telehealth. The telehealth module series is comprised of short 10-15 minute educational videos for busy learners. Learners can decide which modules are of interest and 'earn as they learn' or accrue CME credits with each module completed.
Through these modules you will learn to:
- Perform aspects of a geriatrics assessment in a virtual format
- Discuss capacity, financial decision making, and advance care planning in the context of the COVID-19 pandemic
- Assess and assist with unmet social needs impacted by shelter-in-place orders or quarantining
- Obtain updates on the management of older adults residing in long term care or congregate living facilities as pertinent to primary care providers
Register Now to Start Learning
Cognition
Simple and fast screening tool used to detect cognitive impairment during both routine visits and hospitalizations. Administration takes approximately three minutes. If score is poor, MoCA Tool suggested as follow-up. (#cognition)
How It’s Used: The Mini-Cog Screening Tool is used by our UCSF providers and health care professional partners throughout San Francisco. We have incorporated a series of trainings for professionals at the San Francisco Department of Aging and Adult Services (DAAS) on how to assess clients, manage care, and refer to additional services.
Montreal Cognitive Assessment (MoCA) Tool Screening tool for mild cognitive impairment and dementia. Assesses various cognitive domains such as attention and concentration and conceptual thinking. Administration takes approximately 10 minutes. (#cognition)
How It’s Used: The MoCA Tool has been incorporated into our regular trainings of physicians, health professional trainees, behavioral health clinicians, and social services professionals. Social services professionals, in particular, receive education on how to assess clients with mild cognitive function and information on available services for referral.
National Institute on Aging “Talking with Your Older Patient: A Clinician’s Handbook”A guide available to clinicians to assess cognitive problems, discuss supportive services, and assist the patient and caregiver. (#cognition)
How It’s Used: This clinician handbook is used to provide health professionals guidance on how to address cognition in older adults, refer patients to health and social services, and support patients and family members. This handbook is one of several resources highlighted in the curriculum of our Cognition Key.
Independence
Short Physical Performance Battery (SPPB)
A performance-based, three-part assessment to measure functional status and predict future functional decline. Assessment includes gait speed, balance, and lower extremity strength. Takes approximately 10 minutes to administer.
How It’s Used: The SPPB is a cornerstone to our Medicare AWV+, an enhanced health promotion-focused visit for Medicare beneficiaries. Facilitated by our physician residents and graduate nursing students, the SPPB score provides specific information regarding functional performance.
(Download SPPB Instructions below.)
Simple and accurate screening test to detect hearing impairment. Administration takes one to two minutes.
How It’s Used: The Whisper Test is also utilized in our Medicare AWV+ Visits as a way to identify potential hearing loss or issues and refer patients to audiology services to ensure independence and optimal aging.
(Download Whisper Test Instructions below.)
Safety
“Detecting Elder Abuse and Neglect: Assessment and Intervention”
Article in Journal of American Family Physician
How It’s Used: This resource reviews a variety of tools are available for detecting, assessing, and intervening in cases of older adult abuse and neglect. There is not one tool that we universally recommend for detecting and addressing elder abuse. This resource is highlighted in our Safety Key.
How It’s Used: The CDC STEADI resources and booklets are provided to patients, along with consultation on older adult safety, at the conclusion of each Medicare AWV+ visit. Patients have reported learning actionable steps to improve their safety, independence, and wellbeing as a result of these visits and resources.
Individualized Goal Setting and Decision-Making
“Physicians Guide to Talking About End-of-Life Care”
Article in Journal of General Internal Medicine
How It’s Used: This guide is recommended for physicians, healthcare providers, and trainees on how to engage patients in often-difficult conversations around end-of-life care and advance care planning. It is reviewed and taught in our Individualized Goal Setting and Decision-Making Key.
How It’s Used: We have incorporated comprehensive advance care planning into our Medicare AWV+ Visits. With this resource, our UCSF clinicians and trainees have access to official information from the U.S. Department of Health and Human Services.
An easy, even entertaining way to think about life’s priorities, Go Wish Cards help patients, families, and friends talk about advance care planning and end-of-life wishes.
How It’s Used: A set of Go Wish Cards is provided to all patients upon the completion of an AWV+ Visit. Our physician residents and graduate nursing students use the cards as an opportunity to discuss with older adult patients their health wishes and the importance of advance care planning.
Mental Health
Patient Health Questionnaire (PHQ-9)
Common short screening tool used to identify depression.
How It’s Used: Our UCSF health providers and San Francisco Department of Aging and Adult Services (DAAS) social service professionals regularly utilize the PHQ-9 tool, which has been validated in older adults. We have provided a series of trainings and education sessions on the implementation and use of this questionnaire to screen and identify patients with depression. It is reviewed an taught in our Mental Health Key.
Geriatric Depression Scale (Short Form)
A 15-item, short screening tool utilized to detect depression in older adults. It has been validated in older populations. Administration of questionnaire takes approximately three minutes. It is reviewed and taught in our Mental Health Key.
How It’s Used: In the AWV+ Visits, if the Patient Health Questionnaire is positive, the Geriatric Depression Scale (GDS) is performed. The GDS is a reliable and validated depression screening tool used by our UCSF health providers and San Francisco Department of Aging and Adult Services (DAAS) professionals with older adults who may be at risk of depressed mood.
Generalized Anxiety Disorder (GAD-7)
Seven-question screening tool to identify anxiety disorders.
How It’s Used: The GAD-7 screening tool is used by our clinicians in AWV+ Visits to identify anxiety disorders among older adult patients. UCSF clinicians and trainees also regularly use this tool with patients in visits and screenings. It is reviewed and taught in our Mental Health Key.
SAMSHA-HRSA Screening, Brief Intervention and Referral to Treatment (SBIRT) Tools
Evidence-based resources used for identification, reduction, and prevention of problematic use, abuse, and dependence on alcohol and illicit drugs.
How It’s Used: Our UCSF clinicians and trainees use this tool to identify, assess, and refer older adult patients with alcohol and drug use disorders. This resource provides guidance to our health professionals in engaging older adults to address disorders and refer patients to effective drug and alcohol services. It is reviewed and taught in our Mental Health Key.
Additional Resources
Oklahoma Healthy Aging Initiative AgeASiST Kits
Simulation kits used to provide aging-sensitivity training, including sensations of vision loss, hearing loss, neuropathy, aphasia, and mobility/balance issues.
How It’s Used: We have incorporated the AgeASiST Kits into our regular trainings for local law enforcement including the San Francisco Police Department (SFPD) and San Francisco Recreation and Parks Department (SFRPD). Trainees have the ability to experience symptoms of aging such as hearing and sight loss and mobility limitations.