Comprehensive Geriatric Assessment

Social, environmental and carer domains

Assess social support, carer capacity, isolation, finance and safeguarding concerns. Assess the home environment, accessibility, equipment and community services.

Clinical safety: Use current guidance, local policy and patient-specific judgement.

Learning objectives

• Assess social support, carer capacity, isolation, finance and safeguarding concerns. • Assess the home environment, accessibility, equipment and community services. • Recognise carer strain and the limits of informal support. • Integrate social/environmental feasibility into the clinical plan.

Section 1

Learner handbook (PDF)

Open source ↗

Section 2

Why this module matters

A clinically sound plan can still fail if housing, carers, finances or community support make it impossible to deliver.

Section 3

Core teaching

The social domain explores support, relationships, carer capacity, isolation, safeguarding, finances and what practical help is available. The environmental domain examines safety, access, stairs, heating, equipment, transport, technology and community services. These domains determine whether a clinical plan is actually deliverable.

Carers should be involved with consent and their own needs recognised. A daughter who visits twice weekly is not the same as 24-hour support. Care planning must avoid quietly transferring risk and workload to relatives without discussion.

Environmental assessment should connect with occupational therapy, social care and community teams where needed. The question is not merely “Is the home safe?” but “What needs to change for the person to function there at an acceptable level of risk?”

Section 4

Case step

Mrs Morgan’s daughter works full time and cannot provide daily care. The bungalow has two steps at the entrance and no grab rail in the shower. A discharge plan that assumes constant family support would be unrealistic.

Section 5

Interactive element

Feasibility challenge: learner tests a proposed discharge plan against carer availability, home access, equipment and community-service constraints.

Section 6

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.

Section 7

Reflection prompt

What assumption about family or home support could make a discharge plan unsafe?