| Course | NU 627 Geriatric Healthcare |
|---|---|
| Unit | Unit 1 |
| Paper type | Comprehensive geriatric assessment |
| Length | About 1,030 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Family Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 627 Unit 1
Comprehensive Geriatric Assessment of an 81-Year-Old Woman Whose Daughter Reports She Is "Not Herself"
Student Name
Department of Nursing, Herzing University
NU 627: Geriatric Healthcare
Instructor Name
January 23, 2026
Comprehensive Geriatric Assessment of an 81-Year-Old Woman Whose Daughter Reports She Is "Not Herself"
Patient, Reason for Assessment, and Sources
Mrs. H., a composite 81-year-old retired school secretary, lives alone in a single-story house. Her daughter, who lives 20 minutes away, requested the visit because her mother "is not herself": she has lost weight, missed a church meeting she has attended for decades, and left a pan on the stove last month. The history came from Mrs. H., who was cooperative and answered most questions, and from her daughter, who was present with her permission and who provided collateral on function and recent changes. Where the two accounts differed, both are recorded, because collateral is often more accurate about change over time and the patient is more accurate about her own experience.
Medical Summary
Hypertension, osteoarthritis of both knees, hypothyroidism, and cataract in the left eye. No hospitalizations in the past year. Weight 118 pounds, down from 131 pounds a year ago by clinic records, a 10% loss. Blood pressure 128/72 seated and 112/64 standing at one minute, with lightheadedness on standing.
Function
Basic activities, measured with the Katz ADL index: independent in bathing, dressing, toileting, transferring, and feeding; occasional urinary incontinence, so she scores 5 of 6 (Katz et al., 1963). Practically, she washes and dresses without help but has started wearing pads because she sometimes does not reach the bathroom in time.
Instrumental activities, Lawton Instrumental Activities of Daily Living Scale: she uses the telephone independently, does light housekeeping, and takes her own medications from a weekly organizer her daughter fills. She no longer drives, since last year. Her daughter now does all shopping and has taken over paying bills after two missed payments in the autumn. Mrs. H. still prepares simple meals but reports cooking less (Lawton & Brody, 1969). This is the domain with the clearest recent decline, and her daughter dates most of it to the past six months.
Cognition
Mini-Cog: she recalled one of three words, and her clock drawing placed the numbers correctly but set the hands incorrectly, for a total of 1 of 5, a positive screen (Borson et al., 2000). The Mini-Cog was chosen over longer tools because it takes about three minutes and performs reasonably across education levels and languages; Mrs. H. has 14 years of education and English is her first language, so the result is unlikely to reflect the instrument rather than the patient. A positive screen is not a diagnosis. It indicates the need for a fuller cognitive evaluation, which is planned, and the timing of her changes over six months, along with weight loss and possible low mood, means that depression, medication effects, thyroid dysfunction, and delirium from an intercurrent illness must be considered before a neurodegenerative cause is assumed.
Mood
Geriatric Depression Scale, 15-item short form: 7 of 15, above the usual threshold of 5 that suggests depression (Sheikh & Yesavage, 1986). She endorsed dropping many activities, feeling that her life is empty, and preferring to stay home. She denied thoughts of self-harm when asked directly. Her husband died 14 months ago, and her daughter believes the withdrawal began in the months after. Low mood can produce weight loss, withdrawal, and poor concentration that resemble cognitive decline, which is why mood is screened at the same visit as cognition.
Nutrition, Mobility, and Continence
Nutrition: Mini Nutritional Assessment short form, 7 of 14, indicating malnutrition. She eats one full meal a day and describes food as tasteless since her husband died. Mobility: Timed Up and Go test 13 seconds with a steady gait and no assistive device. She reports one fall in the past year, in the bathroom at night, without injury. Continence: urgency with occasional leakage over the past year, worse at night.
Medications, From the Home
Her daughter brought every bottle from the house. Prescribed: amlodipine 10 mg daily, hydrochlorothiazide 25 mg daily, levothyroxine 75 mcg daily, and oxybutynin 5 mg twice daily, started eight months ago by an urgent care clinician for urgency. Bought over the counter: diphenhydramine 25 mg nightly for sleep, which she has taken for about six months, and naproxen 220 mg two or three times weekly for knee pain. The record listed only the four prescriptions. Two of the six are strongly anticholinergic, oxybutynin and diphenhydramine, and both are recognized as potentially inappropriate in older adults because they can impair memory and attention (2023 American Geriatrics Society Beers Criteria Update Expert Panel, 2023). Their start dates overlap with the onset of her cognitive changes.
Social Circumstances and Safety
She lives alone. Her daughter visits three times a week and calls daily. A neighbor checks on her most mornings. Finances are adequate: a pension and Social Security. She has no smoke detector that works, which her daughter did not know. Nights are the least supported time; no one is present, and her fall occurred at night. She has a health care power of attorney naming her daughter but has not discussed her wishes in detail.
Geriatric Syndromes Identified
Six syndromes were found, and none of them appeared on her problem list: cognitive impairment on screening, new within six months; depressive symptoms, probably dating from bereavement; malnutrition with 10% weight loss; urinary incontinence, longstanding but worsening; orthostatic hypotension, new; and polypharmacy with anticholinergic burden, new within eight months. The new findings carry most of the clinical meaning, because they point to reversible contributors: anticholinergic medications, a thiazide that may be contributing to both orthostatic hypotension and urinary urgency, bereavement-related depression, and poor intake. The value of this kind of multidomain assessment lies in finding these connections, and in hospitalized older adults, comprehensive geriatric assessment increases the likelihood of being alive and living at home months later (Ellis et al., 2017).
Priorities
Clinically: stop diphenhydramine and review oxybutynin; evaluate mood and treat depression; address nutrition; repeat cognitive testing after anticholinergic drugs are removed; review the thiazide; fit a smoke detector. Mrs. H.'s own priority: "I want to stop feeling so tired and flat." Her daughter's priority: safety alone at night. All three are recorded, and the plan will begin where the patient's and the clinical priorities meet, with mood and medications.
References
2023 American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372
Borson, S., Scanlan, J., Brush, M., Vitaliano, P., & Dokmak, A. (2000). The Mini-Cog: A cognitive "vital signs" measure for dementia screening in multi-lingual elderly. International Journal of Geriatric Psychiatry, 15(11), 1021-1027. https://doi.org/10.1002/1099-1166(200011)15:11<1021::AID-GPS234>3.0.CO;2-6
Ellis, G., Gardner, M., Tsiachristas, A., Langhorne, P., Burke, O., Harwood, R. H., Conroy, S. P., Kircher, T., Somme, D., Saltvedt, I., Wald, H., O'Neill, D., Robinson, D., & Shepperd, S. (2017). Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database of Systematic Reviews, (9), Article CD006211. https://doi.org/10.1002/14651858.CD006211.pub3
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function. JAMA, 185(12), 914-919. https://doi.org/10.1001/jama.1963.03060120024016
Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3), 179-186. https://doi.org/10.1093/geront/9.3_Part_1.179
Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist, 5(1-2), 165-173. https://doi.org/10.1300/J018v05n01_09
Reading the NU 627 Unit 1 instructions
The Unit 1 prompt asks for a comprehensive geriatric assessment of an older adult, usually from a case. Expect to cover function, cognition, mood, nutrition, mobility and falls, continence, medications, social circumstances and safety, using a validated instrument for each domain where one exists. Each score should be reported with its threshold and source. Many sections ask you to identify geriatric syndromes and to explain how they interact. The medication review should reflect what the patient actually takes, including over-the-counter drugs. Priorities should combine clinical judgment with what matters to the patient. Informant input, such as from a family member, is often part of the history and should be identified as such. Cite instruments and geriatric guidelines in APA 7. Work from a composite case and keep within your section's page range.
How this NU 627 Unit 1 example is built
The assessment opens with the patient, who requested it and why, and the sources: the patient, her daughter and the pharmacy record. A brief medical summary leads into the domains. Function is scored with the Katz index for basic activities and the Lawton scale for instrumental ones, showing she now struggles with finances and medications. Cognition uses the Mini-Cog with each part reported. Mood uses the short Geriatric Depression Scale with the items she endorsed. Nutrition, mobility and continence are measured together. The medication section is built from every bottle her daughter brought, which uncovers two anticholinergic drugs not on the record. Social circumstances and safety cover living alone, support visits and finances. The syndromes section lists six findings, and the priorities section orders them, starting with stopping diphenhydramine and reassessing cognition afterward.
Reading the NU 627 Unit 1 rubric
Herzing rubrics for this assessment usually reward breadth across domains, correct use of instruments, interpretation, identification of syndromes, prioritization and writing. Breadth points require every major domain to be addressed. Instrument points depend on validated tools reported with scores, thresholds and citations. Interpretation is credited when results are explained for this patient, for example linking a positive cognitive screen to medications that may be causing it. Syndrome identification often carries significant weight, and markers look for findings that were missing from the problem list. Prioritization is scored on a clear order that reflects risk and the patient's wishes. Writing points cover organization by domain, concise reporting and APA citations for each instrument and for the medication criteria used.
Common NU 627 Unit 1 mistakes, and how to avoid them
Geriatric assessments often lose points by reading like an ordinary adult history with a few extra questions, instead of a domain by domain evaluation. Students also report a screening result as a diagnosis, for example calling a positive Mini-Cog dementia. Instruments are frequently named without the score or the threshold. The medication review is a common weak point when it relies on the chart instead of what the patient takes at home. Another gap is missing informant information or failing to say who provided it. Syndromes are sometimes listed without connection to each other, even though medications, mood and nutrition often interact. Finally, priorities should include what the patient wants; a plan built only on clinical findings can miss her main concern.
Get a NU 627 Unit 1 example written to your instructions
Send the Unit 1 instructions and the rubric from your NU 627 classroom, plus the patient case your assessment covers. We write a custom example with each domain measured by a named instrument and the syndromes identified, returned in 24 to 48 hours. The first custom sample is free.
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NU 627 Unit 1 questions, answered
What makes this different from a thorough adult history?
The domains. Function, cognition, mood, nutrition, mobility, medication burden and social support are assessed formally here, and in older adults they predict hospitalization, decline and mortality better than the diagnosis list. A comprehensive adult history that covers systems thoroughly and never measures function has answered a different question.
Does the choice of screening instrument matter?
Considerably. Cognitive screens vary in how they perform across education levels and languages, and using one poorly matched to your patient produces a result that says more about the tool than the person. Name the instrument, say why it suits this patient, and interpret the result with that context rather than treating the cutoff as absolute.
How do I capture the real medication list?
Ask what is actually taken, not what was prescribed. Over-the-counter analgesics, supplements, sleep aids and medication borrowed from a spouse are frequently where the important interactions sit, and none appear in the record. A brown bag review, where everything in the house is brought in, remains the most reliable method and is worth describing in the assessment.
Where can I find a free NU 627 Unit 1 sample paper?
The full NU 627 Unit 1 geriatric assessment is on this page free, covering every domain with its instrument and score, the six syndromes and the priorities. If your case is a different older adult, request a custom assessment; it is free and normally sent within two days.
What instruments are used in a comprehensive geriatric assessment?
Common choices are the Katz and Lawton scales for function, the Mini-Cog or MoCA for cognition, the Geriatric Depression Scale for mood, the Mini Nutritional Assessment for nutrition and the Timed Up and Go for mobility. Report each score with its threshold.