10 minute comprehensive

geriatric screening
Minerva O. Vinluan, MD, MSC CHHM
MEDICAL SPECIALIST IV –NATIONAL PROGRAM MANAGER
DEPARTMENT OF HEALTH

CARLA JEAN J. BERTE, RN

NURSE III - PROGRAM ASSISTANT
DEPARTMENT OF HEALTH
 Learning Outcomes Assessment of
Learning
Outcomes
1. To detect elderly health issues commonly Pre-and Post-Test
overlooked at the primary health care level;
2. To be able to conduct initial assessment, proper
management and referral of the elderly
10 minute comprehensive
geriatric screening
Patient Information:
Name: __________________ Date of visit: ________________

Age: ____________________ Birthdate:____________

Sex: _____Male _____Female

A. Memory
Instruct: “I am going to name 3 objects: paper, pencil, cup. I will ask you to repeat
their names now and then again a minute from now. Please try to remember them”

Record this after asking question on physical functional capacity

(Item D)

Ask for three items recall: 1) ________, 2) _________, 3)__________

(you may use other items if you wish but not lengthy)

Are all 3 objects named? YES_____ NO_____

If NO, refer to “primary health doctor for clinical process of managing memory
loss”
B. Urinary Incontinence
Ask: (check all that apply)
• During the last three months, have you leaked urine (even a small amount)?
YES____ NO ____
• When you were performing some physical activity as coughing, or sneezing or
exercise? YES____NO____

• When you had the feeling that you needed to pee, but you could not get to
the toilet fast enough? YES____NO____

• Without a sense of urgency or physical activity? YES____NO____

• If any of the 4 questions are YES, refer to the primary health physician for
further assessment as medication review, counselling and treatment as
indicated.
C. Depression
Ask: During the past month have you been bothered by feeling
depressed or hopeless? YES__NO__

If YES, refer to primary health doctor for further assessment.

D. Physical Functional Capacity (Immobility)
Ask about basic activities of daily living activities as:
• Are you able to change your clothes without assistance?
YES ____ NO ____
• Are you able to take your bath without assistance?
YES____ NO ____
• Are you able to eat your meals without assistance?
YES____ NO____
• Can you comb your hair/ groom yourself without assistance?
YES____ NO ____
• Are you able to move around your house without assistance?
YES____ NO ____
If any of the 5 questions are NO, refer to primary health physician for further assessment
and management.
E. Falls
Ask: Have you fallen 2 or more times in the past 12 months?
YES___ NO___
If NO, proceed to item on Nutrition. If Yes, ask:
1. What were you doing before you fell? ______________________
2. How did you feel before you fell? ______________________
3. What part of your body hit when fell? ______________________

• Conduct Time Up and Go Test and Functional Reach Test.

If the patient is unable to pass the test, refer patient for further
evaluation and management.
F. Nutrition
Ask: Have you noticed a change in your weight over the last 6 months?
YES___ NO ___

Weigh patient and record. Validate and compare with previous

weight record (if any).

Date: _________Today’s weight: ________kg (Increase/Decrease).

Conduct nutrition counselling before referring to primary health
physician.
G. Hearing
Stand behind the person and ask to repeat after you in normal voice:
Five, Eight, Ten

Right ear: YES___ NO ___

Left ear : YES___ NO ___

Negative screen: If both are YES, patient is able to hear in both ears.
Positive screen: If any NO, patient is unable to hear in both ears or in
one ear, refer to primary health physician.
H. Vision
Ask: “Do you have difficulty reading or doing any of your daily activities
because of your eyesight? YES ___ NO ___

If YES, ask to complete visual acuity test using SNELLEN eye chart,
visual field test using finger counting and Ishihara Color Blindness Test
(with and without eyeglasses)

Visual Acuity Test Visual Field Test Ishihara Color Blindness

(SNELLEN) (Finger Counting) Test

Right eye: YES __NO__ Right eye: YES __ NO __ Right eye: YES __ NO__
Left eye : YES __ NO __ Left eye : YES __ NO __ Left eye : YES __ NO__
Negative screen: If both are YES, patient is able to see in both eyes in
all eye examinations.

Positive screen: If any NO, patient is unable to see in both eyes or in

one eye in any examinations, refer to primary health physician for
further assessment and management.
References
• Age-Friendly Primary Health Care Centers Tool Kit WHO 2008
• https//www.aplaceformom.com
• Dr. Grace Silva and Dr. Nathalie Declarador’s presentation on the
Elimination Problems of the Elderly
• https//www.webmd.com/depression
• https//www.ncbi.nlm.nih.gov/pmc/article
• Dr. Alvin Mojica’s Presentation on Fall Prevention
• https//www.msdmanuals.com/home/eye-disorders
Thank you.