Comprehensive functional assessment of the elderly

The addition of function assessment in a formalized way into the primary care delivery for elderly patients can be viewed as an extension of the traditional concerns of primary care physicians when asking patients how they are doing. Functional assessment strategies simply provide a format for doing this in a reproducible, recordable, and reliable fashion. Although the complexity of functional assessment instruments can be intimidating to clinicians, the principles behind instruments of functional assessment are quite familiar. Physicians already are doing a significant amount of this performance assessment, though frequently it is not labeled as such. Table 8 provides a summary of these performance functional assessments that are easily accomplished in an ambulatory setting and applicable to the hospital or long-term care setting. The direct observation of these elements, combined with the selection of an appropriate assessment instrument for functional assessment, should allow for enhanced patient assessment and better application of the biopsychosocial model of medical care into practice to benefit the future care of our geriatric patients.