Geriatric Evaluation & Management

What is a geriatric evaluation and management assessment?

A geriatric evaluation and management (GEM) assessment is a consultative resource for patients, their family members and caregivers, and their primary care physicians.

The assessment provides a comprehensive assessment of an older adult's health issues in the context of social and family needs, and it provides a comprehensive plan for managing the person’s conditions and care.

A geriatric evaluation assessment also provides education and patient-specific information about health problems as well as information about and access to community and private supports for patients and caregivers.

When is a geriatric evaluation and management assessment appropriate?

A geriatric evaluation and management assessment is advised if you are concerned about your loved one's ability to live independently or if the person is experiencing any combination of the following symptoms:

  • Multiple health problems
  • Confusion or memory loss
  • Behavioral changes, including sadness, depression or anxiety
  • Difficulty performing daily activities
  • Balance and walking problems
  • Weakness, caused by deconditioning of the muscles or other health problems
  • Nutritional concerns, including unexplained weight loss
  • Problems related to the use of multiple medications, including dizziness or falls
  • Uncertainty about the person's ability to live independently.

What should I or my loved one bring to a geriatric evaluation and management assessment?

For the initial geriatric evaluation and management appointment, bring:

  • All medicine containers
  • Medical records for care obtained outside Cleveland Clinic's system of hospitals and family health centers
  • Details of past illnesses, surgeries, allergies, etc.
  • Current insurance information
  • There is no need for a patient to refrain from eating, but please plan to arrive 30 minutes early.

What should I or my loved one expect during the initial geriatric evaluation and management assessment?

An initial GEM assessment may last two hours or more. During the assessment, Cleveland Clinic geriatricians will work closely with a team of healthcare professionals - including clinical nurse specialists, social workers, physical therapists and pharmacists - to complete a comprehensive evaluation. Laboratory, X-ray/imaging studies and other referrals will be made as needed.

Using a holistic approach, the Cleveland Clinic team will evaluate and assess the patient's physical health, mental health, functional status, social support system, economic status, as well as the accessibility and safety of the person's living environment. During the assessment, the person's levels of social and emotional support and physical functioning will be evaluated. The nurse also will screen the patient for depression and memory impairment and gather information about social supports and living conditions.

When the initial GEM assessment is completed, the geriatrician will:

  • Review the medical evaluation with you and your loved one
  • Suggest referrals to other specialists as needed
  • Schedule an appointment for a follow-up visit.

What should I or my loved one expect at the follow-up for the geriatric evaluation and management visit?

At your follow-up visit, the physician will present a full medical, psychological and social evaluation that provides:

  • A clearer understanding of your loved one's health problems and psychological issues
  • A full and comprehensive assessment of the person's needs
  • A plan of care to optimize the person's medical treatments, functioning and quality of life
  • A list of options to consider regarding the person's health issues
  • Advice and help with difficult decisions regarding living arrangements, home safety and end-of-life issues
  • Information and Referrals for all appropriate services and programs services
  • This information will also be provided to your loved one's primary care or referring physician.

During your follow-up visit, arrangements can be made for ongoing GEM consultations to help deal with issues that tend to require ongoing review, such as living arrangements, caregiver needs, health insurance and legal issues and even caregiver needs.

What is the cost of a geriatric evaluation and management assessment?

Costs of the physician consultation are covered by Medicare Part B and most private insurance plans. Costs of diagnostic tests and referrals to team members also are covered by Medicare Part B and most private insurance plans. Specialists may bill separately, but referrals for additional services will be reviewed with you before they are ordered.

How do I make an appointment for geriatric evaluation and management assessment?

You may make an appointment yourself, or the patient's physician may refer the person for evaluation. In addition, the GEM program also accepts referrals from community healthcare providers, including local offices on aging and senior centers.

To make an appointment at any of our locations, please call 216.444.5665

  • Cleveland Clinic
  • Cleveland Clinic Beachwood Family Health Center
  • Cleveland Clinic Elyria Family Health and Surgery Center (Chestnut Commons)
  • Euclid Hospital/Cleveland Clinic Health System
  • Cleveland Clinic Lakewood Family Health Center
  • Cleveland Clinic Lorain Family Health Center

Reviewed by a Cleveland Clinic medical professional.

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