Comprehensive Geriatric Assessment (CGA) is recognised as the gold standard for the care of people with moderate to severe frailty. There is evidence that CGA carried out in the community reduces the risk of admission both to hospital and to nursing homes for older people with frailty.

CGA is a complex, multi-dimensional and multi-professional diagnostic and treatment process. It involves coordinated and specialist geriatric care with an approach that incorporates individually focused multi-disciplinary assessment, alongside targeted interventions, care planning and proactive case management.

CGA reflects the fact that the health and wellbeing of older people extends well beyond the traditional medical management of illness and needs to include systematic consideration of the wider psychosocial, cognitive, functional and environmental aspects contributing to health and wellbeing alongside the management of medical conditions.

CGA is a multi-professional process that is usually led by a core multi-disciplinary team with the ability to draw upon the expertise of a wider ‘virtual team’ with a range of professionals selected according to individual patient needs. The range of professionals who can be involved includes geriatrician, general practitioner, psychiatrist, general nurse, psychiatric nurse, social worker, physiotherapist, occupational therapist, speech and language therapist, dietician, psychologist, pharmacist, dentist, podiatrist, audiologist and optician.

The overall process of the CGA can be described in several stages:

  • The process of information gathering;
  • Discussion of this information by the team, including the patient and, whenever possible, their carer, in order to complete the assessment phase of the process;
  • Development of a treatment plan;
  • Implementation of the treatment plan;
  • Monitoring and reviewing of the treatment plan (supported self-care plan), and revision as necessary, to take account of progress and / or emergent outcomes.

The components of the Comprehensive Geriatric Assessment (CGA) evaluated during the assessment process should include:

  • Medical conditions, polypharmacy and nutrition / weight change;
  • Functional capacity, including falls risk, urinary continence, vision, hearing, dentition;
  • Cognition and mood;
  • Social circumstances and support;
  • Living situation and financial concerns;
  • Goals of care and advanced care preferences.

As well as this wider multidisciplinary assessment, the development of individualised care and support plans, which include plans for how to maintain somebody’s condition, as well as plans for escalation or urgent care, in times of need and advance care, or end of life planning when appropriate, are a key part of the process of CGA.

Find out more

Fullscreen Mode

Access the British Geriatric Society (BGS) CGA Toolkit here

Access the BGS Hospital Wide CGA study here