317 Analysing the social history aspects of an integrated care comprehensive geriatric assessment incorporating patients views and wishes

Abstract

Abstract Background An evaluation of social well-being is an important component of a Comprehensive Geriatric Assessment (CGA). There is no clear guidance about how best to structure and examine these factors as part of a CGA. We sought to examine current practice with respect to the collection of information from a social care perspective across different integrated care CGA proformas. Methods We completed a cross sectional study of the social care domain of integrated care based CGA proformas. All operational leads for each integrated care hub in the country were contacted and invited to share their local CGA. We completed a thematic analysis of the social care section including social, financial and wellbeing assessments. Results We included 16 different CGAs that are in use across different integrated care hubs. All CGAs had a dedicated section for assessing social history with variability in what was included in different CGAs. Patient’s wishes and expectations were commonly included but the manner in which they were collected and emphasis varied. 7 (43%) specifically captured whether the patient has an enduring power of attorney in place, 5 (31%) collected information about formal advanced care directives, and 2 (12%) enquired about nominated assisted decision makers. Ability to manage finances was captured through the Lawton Brody IADL scale in two CGAs. Half of CGAs included a section to capture carer strain and the term ‘next of kin’ was used in 6 of 16 CGAs. Conclusion There is significant heterogeneity in the structure of the social care section of a CGAs across different integrated care hubs, particularly with respect to capturing information surrounding advanced care planning. Signposting of patients’ wishes and expectations was useful for focusing on patient-centred care.