Comprehensive Geriatric Assessment
Nutrition, continence, pain and sensory health
Identify undernutrition risk, swallowing issues, dehydration and oral-health contributors. Assess continence, pain, vision and hearing as functional determinants.
Learning objectives
• Identify undernutrition risk, swallowing issues, dehydration and oral-health contributors. • Assess continence, pain, vision and hearing as functional determinants. • Recognise how these domains interact with delirium, falls and rehabilitation. • Create targeted actions rather than a list of abnormalities.
Learner handbook (PDF)
Open source ↗Why this module matters
Nutrition, continence, pain and sensory impairment are often under-recognised but can determine whether rehabilitation succeeds or fails.
Core teaching
Nutrition, continence, pain and sensory health are often treated as secondary problems, yet each can determine recovery. Undernutrition reduces strength; dehydration worsens delirium and renal injury; pain limits mobilisation; urinary symptoms can contribute to falls; hearing loss can impair communication and cognition testing.
The purpose of assessment is not to create a long list. Each finding should connect to an intervention, owner and review point. Swallowing difficulty, weight loss or poor intake may require dietetic or speech-and-language input; continence issues may need medication and functional review as well as urological assessment.
Sensory aids should be available and working. Simple measures such as ensuring hearing aids are fitted can materially improve communication, orientation and participation in rehabilitation.
Case step
Mrs Morgan has eaten poorly for several days, has lost weight over recent months, avoids drinking because of urgency, and her hearing-aid batteries are flat. These details materially change the CGA plan.
Interactive element
Hidden-contributors exercise: nutrition, oral intake, continence, pain, vision and hearing are revealed sequentially; learner updates the care plan as each changes recovery potential.
Practice points
- Document baseline as well as current state.
- Use collateral information when history is incomplete.
- Convert every important finding into an action or explicit decision not to act.
- State uncertainty rather than disguising it as a score.
- Name ownership and review whenever the plan crosses teams or settings.
Reflection prompt
Which “small” domain - nutrition, continence, pain or sensory health - do you most often see missed?
