Functional assessment in older patients. Key to improving quality of life.

Functional assessment in older patients focuses on their level of functioning rather than on medical diagnoses alone. Patients who have multiple medical problems also have functional and support issues that affect their quality of life. Areas of concern include basic and instrumental activities of daily living, balance and mobility, mental ability, vision and hearing, bowel and bladder function, nutritional status, and environmental factors. Formal geriatric evaluation and management units composed of a physician, a social worker, and a nurse have been developed to address the functional needs in this population. However, primary care physicians can effectively apply the functional assessment approach in evaluation of their older patients with the help of the three-part problem list, along with selected tests and rating scales.