A geriatric assessment is a complete evaluation designed to assess the health and well-being of an older adult. It is different from a typical doctor's visit, as it's a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional limitations in order to develop a coordinated plan of care. The duration of this process varies significantly, ranging from a quick screening to a multi-hour or multi-visit evaluation. Understanding the different types of assessments and the factors that influence their length is key to knowing what to expect.
Types of geriatric assessments and their durations
There is no one-size-fits-all geriatric assessment. Instead, the process is tailored to the individual's needs, which directly impacts the time it takes. Assessments can be conducted by a single practitioner or by a multidisciplinary team of specialists.
Rapid geriatric screening
Rapid geriatric assessments are quick, targeted screenings used to identify specific areas of concern. These are typically performed in a clinical setting to screen for conditions like frailty or cognitive impairment.
- Duration: A rapid screening tool can take as little as 5 to 20 minutes.
- Purpose: These are not comprehensive evaluations but are instead designed to quickly flag potential issues that require a more in-depth assessment. Examples include the Rapid Cognitive Screen (RCS) for cognitive function.
- Personnel: They can often be administered by a non-geriatrician health professional or other members of the care team.
Comprehensive geriatric assessment (CGA)
The comprehensive geriatric assessment is a detailed evaluation that covers multiple domains of an older adult's health and life. It is the gold standard for creating a coordinated and integrated care plan.
- Duration: A comprehensive assessment can take 90 minutes or longer for a single-provider consultation, and a full multidisciplinary review can take 2.5 hours or more when factoring in all necessary appointments, care plan development, and documentation. A study on patients in a transitional care setting found the CGA took around 56 minutes to complete using a suite of assessment tools.
- Purpose: The goal is to provide a complete picture of the patient's medical, psychological, and functional capabilities to develop a long-term strategy that optimizes their overall well-being.
- Personnel: This often involves a multidisciplinary team, including a geriatrician, social worker, nurse, and therapists.
Rolling assessments
For patients with multiple health concerns, a "rolling" assessment over several visits may be utilized. This approach targets different aspects of the individual's health during each office visit, preventing the need for one very long session. This also gives providers the chance to pace the process for older adults who might have chronic illnesses and are at risk for functional decline.
Factors that influence assessment duration
Several key factors can make a geriatric assessment longer or shorter. The more complex the individual's health needs, the more time will be required.
- Patient's Health Complexity: Individuals with multiple chronic conditions, severe frailty, or advanced dementia will require a longer, more detailed assessment. A patient with complex health issues or cognitive impairment may need more time to communicate effectively, which extends the evaluation period.
- Involvement of a Multidisciplinary Team: A comprehensive assessment involving multiple specialists—such as a pharmacist, physical therapist, and social worker—will take more time than one performed by a single physician. This approach may involve separate consultations with each specialist.
- Patient's Cognitive and Functional Status: A patient's level of cognitive function can affect the duration. Those with significant memory problems may need a more comprehensive evaluation, including time for caregiver interviews. Similarly, assessing an individual's ability to perform daily activities may require observation and more detailed questioning.
- Preparation: The amount of preparation done beforehand can reduce the time required on the day of the appointment. Bringing organized information, including medication lists and medical records, helps the healthcare team work more efficiently.
- Setting: The location of the assessment can also play a role. Assessments can be conducted in clinics, hospitals, or the patient's home, and the setting can influence how the process is structured.
Comparison of assessment types
| Feature | Rapid Screening | Comprehensive Assessment | Rolling Assessment |
|---|---|---|---|
| Duration | 5 to 20 minutes | 90 minutes to 3+ hours | Stretched over several visits |
| Purpose | Quickly identify potential problems like frailty or cognitive decline | Create a holistic, multi-dimensional care plan | Systematically evaluate multiple health domains over time |
| Scope | Targeted, focused on specific risks | Holistic, covering medical, psychological, and functional issues | Segmented, addressing different domains on separate occasions |
| Team | Can be single provider or non-specialist | Often involves a multidisciplinary team | Can involve multiple providers over time |
| Patient Profile | Used for screening generally healthy or mildly frail older adults | Frail older adults with complex problems | Patients with many complex concerns that are difficult to cover in a single visit |
Conclusion
How long a geriatric assessment takes is highly variable and depends on the depth and scope of the evaluation. While a rapid screening can be completed in under 20 minutes, a comprehensive assessment involving multiple specialists and addressing complex health issues will take considerably longer, often 90 minutes or more. Patients and caregivers can help streamline the process by preparing thoroughly with organized information, including all relevant medical records and a complete medication list. Ultimately, the duration is determined by the patient's specific health needs and the chosen assessment approach, all with the goal of improving their quality of life and developing a personalized care plan.
For more resources on geriatric health, consult the Merck Manuals Professional Version.
