Age-friendly Primary Health Care Centres Toolkit - World Health ...

AGE-FRIENDLY PRIMARY HEALTH CARE CENTRES TOOLKITII.4 Core competencies of geriatric clinical assessment and key clinical managementapproachesClinical backgroundOlder people often have multiple complex health and social conditions and may alsopresent with vague complaints such as dizziness. These intertwining symptoms aredifficult to diagnose and treat in the limited time available at most primary care settings.Many of these conditions are chronic and must be screened, early detected andmanaged to prevent avoidable complications and disability such as amputation fromdiabetes.It is not possible to include all geriatric assessment and treatment approaches in thistoolkit. The focus therefore, is on assessment and key management strategies for thefour geriatric giants: memory loss, urinary incontinence, depression and falls/immobility.In addition, the diagnosis and key management of hypertension and diabetes – the twomajor chronic diseases which account for a high portion of illness and disability – are alsoincluded.General ObjectivesThis part aims to sensitize and train PHC workers to the approach and use of thenecessary tools to deal with the above-mentioned four geriatric giants and two majorchronic diseases.Who should use the tools?Some PHC settings are staffed with doctors and nurses, while some only have nurses orcommunity health workers. Each tool is marked with a recommendation for the lowestlevel staff to use the tool. A characteristics table is provided for each tool, that specifiesthe more adapted staff to use the tool ("by whom?"). Some staff will require trainingbefore being competent in use of the tools.Contents:II.4.1 Overall examinationII.4.1Clinical assessment and key management approaches for the four geriatric giantsGeriatric Giant 1: Memory LossGeriatric Giant 2: Urinary IncontinenceGeriatric Giant 3: DepressionGeriatric Giant 4: Falls/ImmobilityII.4.2 Clinical assessment and key management approaches for the two major chronicdiseasesManagement of hypertensionManagement of diabetes36