One of the most challenging aspects of geriatric medicine is developing a comprehensive understanding of the many domains that characterize geriatric patients’ well-being and function. In addition to the customary medical considerations, it is necessary to undertake a thorough evaluation of several other components (such as cognitive function, physical function and social function) that play a more prominent role in overall health as people age. These multiple domains contribute to the patients overall condition and to their goals of care. As an introduction to medical students and those new to geriatric medicine, the content included in this website is meant to help the learner appreciate how the relevant domains may be evaluated using standard instruments and how they interact with each other.
Rather than providing a list of facts, graphs or tables, we present the geriatric-relevant domains as a scaffold. This scaffold will enable the learner to visualize how the domains are both connected and overlapping. Like the steel girders that support a building, this scaffold will facilitate the categorization and manipulation of knowledge in a way that is logical, easy to recall. Additionally, it will remain a suitable framework for further elaboration as the learner advances in their practice of medicine.
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At the center of our scaffold is our geriatric patient. The scaffold, which outlines the five major domains (Medical, Cognitive, Functional, Psychosocial and Complexities), branches off from the patient. This scaffold is the organizational framework. Then, within each domain, details and nuances are elaborated and the "cross talk" between domains is presented. After exploring the scaffold and its components, the learner will appreciate how the domains impact the care of individual patients to varying degrees.
The Geriatric Scaffold was created by Dr. Albert Bui. Additional help was provided by Dr. Gail Greendale, Dr. Susan Leonard, and Dr. Heather D'Adamo. Special thanks to Matt Long for providing technical expertise on the project.