How do you get an elderly person evaluated? Your guide to comprehensive geriatric assessment

Oct 15, 2025 5 min read •

elder care caregiving Geriatric Health

According to the American Academy of Family Physicians, nearly one-third of community-living older persons fall at least once per year. When observing worrying signs, such as frequent falls or cognitive changes, caregivers often ask: "How do you get an elderly person evaluated?" The process involves understanding various health domains, engaging medical and legal professionals, and navigating resistance with patience and care.

Quick Summary

This guide outlines the practical steps for initiating a comprehensive geriatric assessment for an elderly person. It covers the initial approach, involving medical professionals like geriatricians and neurologists, and navigating potential challenges, including refusal of care and legal considerations for mental capacity. The process involves a multidisciplinary team to address physical, cognitive, and psychosocial needs.

Key Points

Start with compassionate conversation: Approach the elderly person with empathy and understanding, focusing on your love and concern rather than their perceived failings.
Involve their primary care doctor: Your first step should be to schedule an appointment with their long-standing primary care physician to discuss your observations and concerns.
Seek specialist assessments: Be prepared to work with a multidisciplinary team, including a geriatrician, neurologist, and social worker, based on the PCP's recommendations.
Document all observations: Keep a detailed log of specific incidents, behaviors, and health changes to provide a clear and objective picture to medical and legal professionals.
Prepare for refusal: If they refuse care, involve trusted family or friends, or consider contacting Adult Protective Services or an elder law attorney for severe cases.
Understand legal options: In situations of compromised mental capacity, legal interventions like guardianship or power of attorney may be necessary, but these are typically last resorts.
Leverage community resources: Use resources like the Eldercare Locator or the Aging Life Care Association to find local support services and geriatric professionals.

Recognizing the Need for an Evaluation

Observing signs of decline is the first step toward getting an elderly person evaluated. Changes can be subtle or dramatic, but paying close attention to your loved one’s physical, cognitive, and mental health can provide crucial information for their medical team. It is often a process initiated by a concerned family member or caregiver who has noticed worrisome changes in behavior, functionality, or overall health.

Identifying Signs of Decline

Cognitive changes: Memory loss beyond normal aging (e.g., repeating stories, forgetting how to perform familiar tasks), difficulty with problem-solving, or changes in language skills.
Physical health issues: Unintentional weight loss, frequent falls, poor hygiene, incontinence, or increasing frailty.
Behavioral changes: Unexplained mood swings, increased anxiety, social withdrawal, or poor decision-making.
Self-neglect: Forgetting to pay bills, keeping a messy or unsafe home, or not taking medications properly.
Medication mismanagement: Difficulty keeping track of multiple prescriptions, missing doses, or experiencing adverse side effects.

The Evaluation Process: Steps to Follow

Getting a loved one evaluated involves a multi-pronged approach that begins with open, honest communication and progresses through medical and, if necessary, legal channels.

1. Initiate a compassionate conversation

Approaching your loved one directly and gently is the first and most critical step. Express your concerns from a place of love and worry, not judgment. Instead of saying, “You're not eating enough,” try, “Mom, I’m worried you don't have much food in the house. Could I help you order groceries?” This validates their feelings while offering practical solutions.

2. Schedule a medical consultation

The primary care physician (PCP) is your main starting point. Since older adults often have multiple health conditions, a PCP familiar with their medical history is best equipped to screen for cognitive issues, medication side effects, and other physical problems.

To prepare for this visit:

Create a detailed list of all medications, including prescriptions, over-the-counter drugs, and supplements.
Document specific examples and dates of concerning behaviors or incidents.
Bring a signed Health Insurance Portability and Accountability Act (HIPAA) release form. This is crucial for allowing the doctor to share information with you.
If possible, attend the appointment with your loved one to share your observations directly with the doctor.

3. Seek specialist assessments

Depending on the PCP's findings, they may recommend further evaluation by a specialist.

Geriatrician: A doctor who specializes in age-related medical conditions and complex health issues, especially when managing multiple chronic illnesses.
Neurologist/Neuropsychologist: These specialists can provide in-depth cognitive assessments, including the Montreal Cognitive Assessment (MoCA) or Mini-Mental State Exam (MMSE), to diagnose dementia or other neurological conditions.
Geriatric Psychiatrist: For mental health concerns like depression, anxiety, or severe behavioral changes, a geriatric psychiatrist can conduct a comprehensive mental health evaluation.
Occupational and physical therapists: These specialists can assess functional abilities, such as daily living activities (ADLs) and mobility, and provide recommendations to improve independence and home safety.

Navigating Refusal of Care

It can be distressing when an elderly person refuses needed help, especially if their safety is at risk. Here are some strategies:

Understand their fears: Listen to their reasons without judgment. Are they afraid of losing independence? Concerned about cost? Addressing their specific worries can open the door to finding a compromise.
Involve trusted voices: Sometimes, a trusted family member, close friend, or spiritual leader can be more persuasive than a primary caregiver.
Engage Adult Protective Services (APS): If the person is at immediate risk of harm or self-neglect due to a lack of capacity, involving APS may be necessary. They can investigate the situation and connect the individual with resources.
Pursue legal options: For severe cases where an individual is demonstrably unable to make sound medical or financial decisions, legal actions like seeking guardianship or a medical power of attorney may be needed. This is often a last resort and requires documented evidence of declining capacity.

Comparison of Evaluation Paths


Aspect	Routine Geriatric Assessment	Legal Capacity Assessment
Initiator	Patient, family, or PCP during a routine visit.	Concerned family member, attorney, or social services.
Primary Goal	Create a coordinated plan to maximize health and quality of life.	Determine if the individual is legally capable of making their own decisions.
Key Professionals	Geriatrician, social worker, nurse, therapists.	Attorneys, neuropsychologists, and court-appointed evaluators.
Evidence	Doctor's notes, standardized screening results (e.g., MoCA), caregiver observations.	Extensive documented evidence of behavior, medical history, and professional evaluations.
Outcome	Integrated care plan, specialist referrals, or recommendations for increased support.	Court-ordered guardianship, conservatorship, or designation of power of attorney.

Conclusion

Getting an elderly person evaluated is a proactive and compassionate step toward ensuring their safety and maximizing their quality of life. The process begins with recognizing signs of decline and approaching the person with empathy and clear communication. It typically involves a series of medical evaluations, from a primary care provider to specialists like geriatricians and neuropsychologists, who can provide a comprehensive assessment of the person's physical, cognitive, and mental health. While navigating potential resistance can be challenging, involving trusted individuals, social services, and legal counsel for severe cases can ensure the person receives the necessary care. Ultimately, a thorough and coordinated evaluation helps develop a care plan that supports independence while prioritizing well-being.

How to Find Support Resources

If you are a caregiver needing assistance, various resources can help guide you through the process:

Eldercare Locator: A public service of the U.S. Administration for Community Living that connects individuals with local senior services via phone or website.
Aging Life Care Association: Provides a searchable database of professional geriatric care managers who can help coordinate care plans.
HealthinAging.org: Created by the American Geriatrics Society's Health in Aging Foundation, this site offers a tool to find geriatric health professionals in your area.
Area Agency on Aging (AAA): Local organizations that offer information, assistance, and resources for older adults and their caregivers.

Navigating an elderly person's health needs can be complex, but with the right approach and resources, you can ensure they receive the best possible evaluation and care. Start with a loving conversation, gather your information, and leverage professional help to create a supportive and safe plan for their future.

Frequently Asked Questions

A comprehensive geriatric assessment is a multidisciplinary diagnostic process that evaluates an older person's medical, psychosocial, and functional capabilities. It helps identify issues and create a coordinated plan to maximize overall health and quality of life.

While starting with their primary care physician is best, they may be referred to a geriatrician—a doctor specializing in the health care of older adults. For specific issues, a neurologist (cognitive issues), geriatric psychiatrist (mental health), or other therapists may be consulted.

If they refuse, start with compassionate communication to understand their fears. Involve trusted family members or friends. In severe cases involving self-neglect or immediate danger, consider contacting Adult Protective Services or exploring legal options like guardianship.

A geriatric care manager is a professional who can help coordinate all aspects of an elderly person's care, from medical appointments and medication management to navigating living arrangements and managing finances. They can be found through organizations like the Aging Life Care Association.

First, have a gentle and loving conversation about your concerns. Schedule a visit with their primary care doctor and prepare a comprehensive list of medications and specific behavioral examples. Ensure you have a signed HIPAA form to discuss their health.

Before the appointment, create a detailed list of all medications, including dosage. Document any specific signs of decline or concerning incidents. Bring a signed HIPAA release and consider attending the appointment with your loved one to share your observations directly with the doctor.

Legal options are typically for severe situations involving questionable mental capacity. These may include seeking guardianship or conservatorship through the court system, or, if they have one, exercising a medical power of attorney. These steps often require a professional assessment.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.