5Ms Framework in CGA Adaptation

Questions and Answers

What is the primary purpose of the Functional Independence Measure (FIM)?

To evaluate the risk and cognitive needs of patients with severe brain injuries

To assess cognitive function in individuals with brain injuries

To provide a standardized measure of an individual's ability in a clinical setting (correct)

To classify the psychological wellbeing of older adults in rehabilitation

Which of the following accurately describes the 'Supervision or set-up' level of assistance?

The individual performs 50% or more of the task independently.

The individual requires total physical support to complete the task.

The person needs only verbal prompts or assistance setting up necessary equipment. (correct)

The individual is able to complete the task without any assistance.

What does 'Complete independence' mean in the context of activity performance?

The individual performs tasks quickly but with some verbal guidance.

The person can complete tasks but takes longer than usual to do so.

The individual can perform all tasks without any safety concerns or modifications. (correct)

The person requires assistive devices to complete tasks safely.

How does the Rehabilitation Complexity Scale—Extended version (RCS-E) assist clinicians?

It evaluates the complexity of rehabilitation needs for patients with severe brain injuries. Signup and view all the answers

What is the purpose of the Comprehensive Geriatric Assessment (CGA)?

To formulate a holistic care plan and coordinate service delivery for older adults. Signup and view all the answers

Which of the following best describes the term 'modified independence'?

The individual can perform tasks independently but requires assistive devices. Signup and view all the answers

What defines the 'Moderate assistance' level in task performance?

The individual receives hands-on help but contributes between 50% and 74% of the effort. Signup and view all the answers

Which statement regarding integrated care for older adults is correct?

Integrated care requires the formation of a governance structure to support service development. Signup and view all the answers

In assessing cognitive and psychosocial function in patients with brain injuries, which assessment tool is used alongside FIM?

Functional Assessment Measure (FAM) Signup and view all the answers

What are the four main domains assessed in a Comprehensive Geriatric Assessment (CGA)?

Physical, psychological, functional, and social Signup and view all the answers

Which of the following best describes the term 'capacity' as defined by the International Classification of Functioning, Disability, and Health (ICF)?

What an individual can do in a 'standardized' environment Signup and view all the answers

What is the primary focus when setting rehabilitation goals according to the 5Ms framework?

What matters most to the patient Signup and view all the answers

Which of the following is NOT a component of the SMART framework for goal setting?

Transferable Signup and view all the answers

In the context of patient rehabilitation, which goal would be deemed most appropriate under the SMART framework?

The patient will walk 50 meters using a rollator within two weeks Signup and view all the answers

Which of the following statements accurately reflects the definition of 'performance' in the ICF framework?

What a person actually does in their 'current' environment Signup and view all the answers

Which goal aspect in the SMART framework encompasses distinctly defined outcomes?

Specific Signup and view all the answers

What advantage does the International Classification of Functioning, Disability, and Health (ICF) offer in healthcare settings?

It standardizes language for health and disability descriptions Signup and view all the answers

What is the significance of incorporating perspectives from all members of the multidisciplinary team (MDT) when setting rehabilitation goals?

It enhances the patient's experience and treatment outcomes Signup and view all the answers

Study Notes

The 5Ms Framework and CGA

The 5Ms offer a structured approach to personalize Comprehensive Geriatric Assessment (CGA).
Patient rehabilitation goals should focus on what matters most to the patient, considering input from the multidisciplinary team (MDT).
SMART criteria (Specific, Measurable, Achievable, Relevant, Timebound) are useful for formulating rehabilitation goals.
Example of a SMART goal: Patient aims to mobilize 50 meters using a rollator within 2 weeks, prioritizing independence at home and in the garden.

International Classification of Functioning, Disability, and Health (ICF)

The ICF provides a framework for defining and measuring health and disability.
Constructs defined in ICF:
- Capacity: What an individual can do in a standardized environment.
- Performance: What an individual actually does in their current environment.
Measurement tools associated with ICF include the Functional Independence Measure (FIM) and the Functional Assessment Measure (FAM).

Functional Independence Measure (FIM) and FIM+FAM

FIM is an 18-item scale assessing disability, with scores ranging from 1 (complete dependence) to 7 (complete independence).
FAM complements FIM by adding 12 items focused on cognitive and psychosocial functions, specifically for brain injury patients.

Levels of Assistance

Total Assistance: Patient does <25% of the task.
Moderate Assistance: Patient performs 50-74% of the task with help.
Minimal Assistance: Patient performs ≥75% of the task, needing only incidental help.
Supervision/Set-Up: Patient requires cues or set-up assistance without physical contact.
Modified Independence: Patient uses assistive devices or needs more time but maintains safety.
Complete Independence: Patient performs all tasks independently and safely within reasonable time.

Measuring Support Needs

Assessing support needs of patients requires a multidisciplinary approach.
The Rehabilitation Complexity Scale—Extended (RCS-E) evaluates the complexity of rehabilitation in severe brain injury, addressing care, cognitive, medical, therapy, and equipment needs.

Comprehensive Geriatric Assessment (CGA) Overview

CGA involves holistic assessment, care planning, service delivery, and ongoing monitoring, focusing on four domains: physical, psychological, functional, and social.
Initiate CGA when an older individual shows signs of frailty, using validated assessment tools.
CGA serves as a critical diagnostic tool in various settings, including emergency departments.

Integrated Care for Older People

Integrated care aims to provide planned and coordinated services for older individuals with complex needs, moving care from hospitals to community settings.
Effective implementation requires governance to support service development and new operational methods.
The focus is on maintaining older individuals' functional ability and intrinsic capacity for independent living.
WHO ICOPE outlines integrated care pathways for managing priority conditions related to intrinsic capacity loss, emphasizing initial community screening and comprehensive assessments.

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Description

Explore the 5Ms framework as a vital approach to personalizing Comprehensive Geriatric Assessment (CGA). This quiz will guide you through patient cases while emphasizing the importance of setting rehabilitation goals that focus on the patient’s priorities and the multidisciplinary team's perspectives. Engage with the content to deepen your understanding of geriatric care.