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Interdisciplinary Geriatric Assessment:
Mrs. Kell

Family Practice Clinic

Presentation

Mrs. Kell is accompanied to the clinic by her spouse and daughter for her one-month follow-up to her visit for left leg pain. She is in no acute distress. X-rays of the left hip from one month ago show diffuse osteopenia without fractures. At that time she was prescribed Calcium 750mg bid and Vit D 400 IU qd and referred to a physical therapist for instruction in treatment with local modalities such as heat and ice. Her intermittent left leg pain appears to have resolved.

Mr. Kell has noticed an increase in "shakiness" in the past two weeks which has resulted in Mrs. Kell's requiring increased assistance with feeding herself and fastening her clothing. He has also noticed a decline in her ability to get in and out of a chair.

For the past several weeks Mrs. Kell has been having trouble with "panic attacks." She reports several episodes of feeling anxious and short of breath. Sometimes she feels faint during the episodes. She indicates there is no chest pain associated with the attacks nor pain associated with coughing. She has a history of Parkinson's Disease, hypothyroidism, hearing loss, peptic ulcer disease and a cerebral vascular accident. She reports ambulating well, having walked four times in the past week at the mall. She is able to get up using a little pressure on her thighs, walks smoothly, but with a somewhat stooped, estimated gait. She makes good turns with minimal cog-wheeling. Resting tremor is present in the forearms and hands.