The Role of Comprehensive Geriatric Assessment in Elderly Transition of Care

Abstract

The rapidly and exponentially increasing elderly population calls for re-evaluation of the current geriatric care practices, one of them being the process of discharging elderly, frail patients with multiple comorbidities from acute care setting. Current model of discharge after admissions for acute illnesses does not address problems that are common among elderly patients, i.e., multimorbidity, frailty, geriatric syndrome, disability, polypharmacy, and medication confusion. This often leads to hospital readmissions, poor health outcomes, and increased short-term mortality. Comprehensive Geriatric Assessment (CGA) is “a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional limitations of a frail older person in order to develop a coordinated plan to maximize overall health with aging” (Ward & Ruben, 2020). CGA model of assessing frail elderly patients was created over 30 years ago and has shown measurable benefits in multiple high-quality studies. However, it has not been widely recognized by many health care professionals. This evidence-based literature review is designed to evaluate the efficacy of Comprehensive Geriatric Assessment for elderly patients transitioning from inpatient setting to home or long-term care setting, compared to the general discharge practice. The study attempts to evaluate whether CGA model contributes to improving health outcomes, longevity, readmission rates in patients older than 65 years old with multimorbidity and frailty, who required hospitalization for various health conditions and look at the barriers to the implementation of CGA model.