In-Home Comprehensive Geriatric Evaluation and Assessment
Comprehensive geriatric evaluation and assessment is not a new concept. It has been in wide use in the United States since the mid-1980s and its many benefits and advantages have been demonstrated in numerous studies published in the medical literature. In fact, Dr. Oberlender founded the Geriatric Evaluation Unit at the Salem VA Medical Center in 1985 and he served as its Medical Director until 2001. Most geriatric evaluation and assessment units utilize a multi-disciplinary approach, where specialists from a variety of areas perform their individualized assessments and then join together to combine their findings in a written report. These units are traditionally either hospital-based or operate in an outpatient clinic setting. In either case, the patient and their caregivers are required to come to the unit, sometimes for multiple visits. Furthermore, because these units are typically part of a larger health care organization, the clinicians perform their work under time limits set by the organization.
Dr. Oberlender’s approach to the geriatric evaluation and assessment process is different in three fundamental and very important ways. First, he alone as the physician performs every aspect of the evaluation and assessment process and he alone formulates and writes the final report. Second, the entire evaluation and assessment process takes place in the patient’s own home or in the patient’s private room at their assisted living facility. Third, and most important, Dr. Oberlender does not operate under any time constraints. He will take as much time as both you and he need to perform a fully comprehensive and totally complete assessment and evaluation. These three innovative and unique aspects of Dr. Oberlender’s approach offer numerous benefits and advantages to the assessment process.
Dr. Oberlender’s services are consultative. They are intended to provide an in-depth and detailed independent evaluation to help optimize the care you receive from your primary care provider. Dr. Oberlender’s recommendations are to be implemented only under the care and supervision of your primary care physician.
Content and process of the in-home geriatric evaluation and assessment
- Review of medical records supplied by the patient’s primary care physician. This includes a full review of all laboratory and imaging studies that have already been performed.
- Detailed medical history, obtained from both the patient and his/her caregiver(s).
- Detailed medical history, obtained from the patient alone in a private confidential setting.
- Thorough and critical review of all prescription and over-the-counter medications.
- Psycho-social assessment.
- Comprehensive nutritional assessment.
- Physical Examination, focusing on the many changes that occur with normal aging and on the specific problems of each individual patient.
- Mental Status Examination, utilizing both detailed interview techniques and quantitative instruments designed to assess the cognitive abilities of seniors.
- Assessment of affect, looking for underlying anxiety and/or depression. Both detailed interview techniques and specific tools designed to assess the affective state of seniors are utilized.
- Functional assessment, observing the patient performing a variety of necessary daily activities in the home.
- Assessment and evaluation of the primary caregiver(s). This aspect of the process is critical to assuring that the caregiver has the necessary skills and supports to assure that the patient gets the care he/she needs in an uninterrupted manner.
Final Written Report
At the conclusion of the assessment process, Dr. Oberlender will personally prepare a fully detailed written report delineating his findings, his assessments, and his specific recommendations. A signed original of the final report will be sent directly to the patient’s primary care provider together with a cover letter explaining the goals and purpose of the evaluation process. Dr. Oberlender will also personally present this report to the patient and/or caregiver(s) and he will take as much time as it takes to explain its content.