Chances and challenges of comprehensive geriatric assessment training for healthcare providers

Abstract

Geriatrics is the medical specialty that deals with physical, psychological, social and functional aspects of the older adult and represents a most authentic form of personalized medicine. As such, it is successfully performed through its cornerstone instrument, the comprehensive geriatric assessment (CGA), which consistently shows its significant benefits since over 30 years. However, the high speed at which the world population ages and gets affected by chronic conditions, multimorbidity and functional impairment is not yet accompanied by a strong, competent and self-conscious geriatric culture. This unmet need contributes to the further exponential increase of disability and lack of well-being in older persons. In this paper, we give an overview of the possible reasons for the lack of adequate CGA implementation across settings and highlight the likely benefits of consequent training and education of two groups of (future) professionals in the field of aging medicine: medical students and residents on one hand and multiprofessional healthcare providers, particularly nurses and physiotherapists, on the other hand.

The multidimensional prognostic index in hospitalized older adults: practicability with regard to time needs

“…Certainly, the proof of such an effect would require a special study design. Nevertheless, an assessor training in frailty measurement seems to be reasonable with future development of appropriate, more structured instruction and schooling systems in the CGA field [12]. Given an optimum low assessment time of 10 min (median) under our conditions (cohort 3), the MPI positions even more favorable in the ranking position of CGA tools with regard to time expenditure.…”

Effectiveness of multi-professional educational interventions to train Comprehensive Geriatric Assessment (CGA) – a Systematic Review

“…Besides professional standards and ethics, a strong attitude towards patient relations, inter-professional team working, redefinition of roles and relations and/or communication build the ground for an integrated management and organization flow when offering CGA to older people and patients. Understanding how to best equip todays health and social care staff with these core competencies remains a challenge up to this point [48]. Some of the studies included indicated a variability in results according to profession [32,36].…”

The Italian guideline on comprehensive geriatric assessment (CGA) for the older persons: a collaborative work of 25 Italian Scientific Societies and the National Institute of Health

“…Furthermore, CGA can be applied across different care settings (e.g., primary care, hospital, local health and social care facilities), with different types of pathways and levels of intensity. Unfortunately, there are some barriers to the implementation of CGA, such as: 1) an inadequate definition of the characteristics of patients who could benefit the most from a multidimensional care pathway [ 1 ]; 2) a high heterogeneity of operational definitions of CGA [ 7 ]; 3) a lack specific training on CGA for social and healthcare staff involved in caring for older people [ 8 ]; 4) a poor definition of the professional skills required in the interdisciplinary team for drafting, implementing and monitoring CGA-based treatment plans. [ 9 ]…”