Department of Family & Community Medicine

Enhanced Skills Program: Care of the Elderly Geriatric Assessment Rotation Goals and Objectives

By the end of the rotation, the resident will be able to:

Medical Expert

  • Can perform a comprehensive geriatric assessment in frail elderly including use of validated tools in order to diagnose, investigate and manage common geriatric syndromes (cognitive impairment, falls, delirium, depression, urinary incontinence, polypharmacy) with the goal of reducing frailty and functional decline.
  • Demonstrate an understanding of the frailty, its causes, the spectrum and consequences.
  • Recognize the importance of multiple concurrent chronic conditions on health and is able to adjust management plans based on the presence of existing health and social factors, guided by patient wishes.
  • Can perform a comprehensive cognitive assessment including use of validated tools and appropriate focussed physical examination in order to diagnose common forms of dementia. Recognizes the potential role of other health issues in the presentation of decreased cognitive performance in older adults, including delirium, and manages these factors appropriately.
  • Evaluate baseline and current functional abilities using reliable sources of information.
  • Demonstrate the ability to assess risk related to driving safety and manage driving issues with confidence and sensitivity.
  • Can safely prescribe medications for complex older patients, with an understanding of the benefits, risks, limitations, interactions and potential adverse effects.
  • Can effectively recognize and manage problems that caregivers might experience.
  • Be able to identify signs of elder abuse and neglect. Knowledge of resources for management of elder abuse.
  • Accurately assess physical findings commonly seen in the geriatric syndromes (postural blood pressure readings; gait, posture and balance; abnormal motor movements; cardiac murmurs, examination of the feet for skin breakdown, pulses, sensation; examination of the ears for cerumen and hearing acuity, fecal impaction, urinary retention).

 

Communicator

  • Develop rapport, trust and ethical therapeutic relationships with patients and families.
  • Accurately convey needed oral and written information to patient and families,  in a way that is understandable and encourages discussion and participation in decision-making.
  • Discuss the patient and family’s beliefs, concerns, illness experience and specifically focuses on their expectations in terms of goals of treatment and expected outcomes. Attempts to incorporate patient wishes even in situations of diminishing individual capacity.
  • Respect diversity and difference, including but not limited to the impact of gender, religion and cultural beliefs on decision-making.

 

Collaborator

Maintain a positive working environment with consulting health professionals, health care team members, and community agencies.
Participate effectively and appropriately in an interprofessional healthcare team. Collaborate with community agencies (as required) and other professionals

 

Leader

  • Participate in activities that contribute to the effectiveness of their own practice, healthcare organizations and systems.
  • Work collaboratively with other health care professionals and community organizations to provide coordinated care for patients and caregivers.

 

Health Advocate

  • Respond to individual patient health needs and issues as part of patient care. Advocate for individual patients around relevant health matters

 

Scholar

  • Maintain and enhance professional activities through ongoing self-directed learning based on reflective practice.
  • Critically evaluate medical information, its sources, and its relevance to their practice, and apply this information to practice decisions for frail elderly.

 

Professional

  • Demonstrate a commitment to excellence in clinical care and personal ethical conduct. Exhibits proper professional behaviour including adhering to legal and ethical codes of practice.