Tips for Inpatient Geriatric Management, Frailty Assessment

This interview with Ugochi Ohuanbunwa, MD, was conducted following the American College of Physicians (ACP) Internal Medicine Meeting in Boston, with the HCPLive editorial team discussing the primary messages covered in Ohuanbunwa’s presentation at the conference.

Ohuanbunwa, a professor of medicine at the department of medicine’s division of geriatrics and gerontology at Emory University, was asked about her talk titled ‘Inpatient Geriatrics Management: Assessing Frailty and What to Avoid.’ Initially during the interview, Ohuabunwa was asked what an inpatient geriatric assessment looks like for internists during hospitalization.

“One of the major components of the talk was the fact that older adults are at risk of multiple hazards during hospitalization,” Ohuabunwa explained. “The hazards are not just from the primary reason for which the older adult was admitted to the hospital. There are other things that go wrong, things like their cognition, functional decline, and so on. So it’s very important that incorporating those assessments of their cognition assess for their functional status and to for nutrition.”

Ohuabunwa noted that there were a few areas that are known to be best practices which are recommended both by the American Geriatric Society and Society of Hospital Medicine as best practices. These recommendations were discussed during her talk at ACP.

“It is very important for an internist who is admitting older adults for technically non-geriatric syndromes and look at the chief medical illnesses to incorporate into their assessments,” Ohuabunwa said. “Cognitive assessment, functional assessment, frailty assessment, assessment for depression, assessment for malnutrition, and skin assessment. Those are all very important components to include in the assessment of your older adult as part of what you do during the initial assessment.”

Ohuabunwa added that the reason why she decided to bring this up during the talk at ACP was the fact that, most times, clinicians are hyper focused on the reason why the older adult is there,” Ohuabunwa said. “…It’s important that the internist tries to determine what that older adults’ baseline is and then during the hospitalization on a regular basis, do regular assessments for these components. They are very important in informing the outcome of the older adult.”

Ohuabunwa was also asked about how to do a frailty assessment for older adults as an internal medicine physician.

“For functional status assessment, a couple of simple tools,” Ohuabunwa explained. “We have what’s called the Katz score which, essentially, covers what the patient’s basic ADLs are. The higher the score, the more multifunctional that older adult is. There is the Lawton score, which assesses their instrumental activities of daily living. The higher the Lawton score, the more functional that older adult is. So trying to determine those scores is very helpful.”

To find out more from Ohuabunwa’s talk, view the full interview segment posted above.

The quotes in this summary were edited for the purposes of clarity.

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