Acute Medicine | Palliative care | Assessment of physical and cognitive deterioration in function

Assessment of physical and cognitive deterioration in function
Session overview
Description
This session provides a framework for the assessment of physical and cognitive deterioration in function in end-of-life care patients.

This session was reviewed by Richard Kitchen and last updated in January 2020.

Learning objectives
By the end of this session you will be able to:

• explain the importance of regularly assessing physical and cognitive function in end-of-life care patients
• outline the core elements in assessing physical and cognitive function, and the key professionals involved in assessment
• give examples of standardised tools used in clinical practice and research and their utility/limitations
• outline the impact of deteriorating physical and cognitive function on the patient and their family/carers

As any life-threatening illness progresses, it is accompanied by deterioration in both physical and cognitive functioning. This may be insidious or abrupt. In this session you will look at how deterioration can be anticipated and identify an appropriate management strategy agreed in advance with the patient and family.

You will look at how physical and cognitive deterioration in function impacts on the quality of life of the patients as well as of their carers and family, both emotionally and in terms of the physical burden of caring. This is particularly important when the carers themselves are frail and elderly.

You will also gain an understanding of the core steps involved in the assessment of physical and cognitive function. This includes the history, examination and discussion of the assessment tools used in clinical practice.

In addition, you will look at the multidimensional patient assessment and how this approach should take account of the expectations of the patient and family. In this way, realistic expectations or goals can be agreed.