Geriatrics

Clinical Skills | Functional

Functional Activities Domain

Functional Activities presentation graphic cropped

The functional activities domain within the practice of geriatric medicine involves assessing a patient's ability to perform daily activities, gait and fall risk.

  • For our patients who have difficulties performing these functions, geriatricians must pay extra attention to how these issues impact their other major Domains, and vice versa.
  • Can help to diagnose medical problems: Parkinsonian gait, foot drop, etc.

Daily Functional Activities

This includes the patient's ADLs and IADLs.

  1. Download ADLs and IADLs handout
  2. Patients with cognitive deficits (i.e. Dementia) have difficulties performing their activities independently
  3. Get collateral information from family and/or caregivers on true function
  4. Distinguish functional decline due to medical or cognitive limitations

Physical Function: Balance, Gait and Falls Assessment 

A fall resulting in bone fracture, head trauma or other injury has serious consequences in morbidity and mortality. One can use the Tinetti gait and balance assessment to determine if a patient may need one of the following:

  • Outpatient Physical Therapy
  • Durable medical equipment (DME)
  • Skilled Nursing Facility (SNF)
  1. Balance: Assess a patient's ability to maintain their balance
    • Download Stance handout
    • To make it more challenging, ask the patient to cross their arms and close their eyes while maintaining balance
    • Be sure to stand next to patient for safety
  2. Gait/Tinetti: Use the Tinetti gait and balance assessment, a breakdown of the components of balance and gait
  3. Timed get up and go (TUG) test: The TUG test assesses a patient's mobility. Longer times correspond with worse health outcomes.
    • Test instructions:
      1. Rise from sitting position
      2. Walk 10 feet
      3. Turn around
      4. Return to chair and sit down