Permission for Use

Interdisciplinary Geriatric Assessment:
Mr. Fine

Clinical Impression & Action Plan

Three months after leaving the nursing home and returning to his apartment, Mr. Fine's son has accompanied him to his physician's office. The son reports a marked increase in problems with incontinence, balance, fine motor control, verbal communication and fall frequency. The physical examination reveals a marked decrease in neck rotation resulting in a loss of peripheral vision. Mr. Fine is experiencing a rapid decline in all his functional capabilities and his safety during activities of daily living is being compromised. Recognizing the strong support and commitment of his family to assist him with remaining in his apartment as long as possible, the physician has referred Mr. Fine to home health services.

The interdisciplinary geriatric assessment team has been called together to develop a plan of action. This meeting should last about 15 minutes. Print the IGA form. Using it and the information you have for Mr. Fine, act as the team leader for the virtual team.

When you have completed the IGA form including the plan of action, compare your filled-out IGA form to the form developed by our team.