Geriatric Assessment Template

## What's Included

This Geriatric Assessment Template is designed to comprehensively evaluate the physical, cognitive, emotional, and social domains critical to older adults' health. Key sections include detailed patient demographics, medical history, medication review (including polypharmacy risks), functional status assessments (ADLs and IADLs), cognitive screening tools (e.g., MMSE or MoCA), mood and mental health evaluation (depression and anxiety scales), sensory assessments (vision and hearing), and social support network analysis. It also incorporates fall risk assessments, nutritional status, and advanced care planning documentation to guide holistic care planning.

Each section contains standardized fields and checklists to streamline data capture, such as drop-down options for common geriatric syndromes, free-text areas for clinical impressions, and prompts for specific risk factors. The template integrates prompts for mental health screening tailored to geriatric patients, ensuring providers capture subtle cognitive or affective changes that impact overall wellbeing. This structure supports coordinated interdisciplinary care and facilitates consistent documentation for monitoring longitudinal changes.

## Who This Template Is For

This template is specifically designed for geriatricians, primary care physicians, nurse practitioners, physician assistants, clinical psychologists, and mental health clinicians who assess and manage older adults. It is also valuable for multidisciplinary teams including social workers, occupational therapists, and case managers involved in comprehensive geriatric evaluations and care planning.

## How to Use

Begin by completing patient demographic information and reviewing medical and medication history to identify risk factors such as polypharmacy or chronic conditions. Proceed through the functional status and cognitive screening sections, administering standardized tests as indicated and recording results directly in the template. Use the mood and mental health evaluation fields to document observed or reported symptoms of depression, anxiety, or other psychiatric conditions common in geriatric populations.

Incorporate sensory and mobility assessments to identify potential barriers to independence, then evaluate social supports and living environments to inform care recommendations. Utilize the fall risk and nutrition sections to flag areas requiring intervention. Finally, synthesize findings in the clinical impression and care plan fields, ensuring clear documentation of next steps, referrals, and follow-up priorities. This stepwise approach ensures thorough, efficient, and reproducible geriatric assessments.

## Customize with MentalNote

Leverage MentalNote’s AI-powered clinical documentation tools to automatically generate and customize this Geriatric Assessment Template within Microsoft Word. By inputting patient-specific data or voice dictations, MentalNote can populate structured fields, suggest relevant clinical content, and format reports according to best practice guidelines. This automation reduces administrative burden, improves accuracy, and allows clinicians to focus more time on patient care while maintaining comprehensive, standardized documentation tailored for geriatric mental health evaluations.