CASE STUDY 3 - Geriatric Syndrome: Falls, Polypharmacy, and Cognitive Change Case Scenario Mr. A.S. is a 78-year-old male presenting after two falls in the past month. History:
dvanced Primary Care of Family I-HBN-HY01 Luis Serrano
🩺 CASE STUDY 3: Geriatric Syndrome: Falls, Polypharmacy, and Cognitive Change
CASE STUDY 3 - Geriatric Syndrome: Falls, Polypharmacy, and Cognitive Change
Case Scenario
Mr. A.S. is a 78-year-old male presenting after two falls in the past month.
History:
- PMH: HTN, osteoarthritis, insomnia, BPH
- Medications: Hydrochlorothiazide, diphenhydramine nightly, tamsulosin, ibuprofen PRN
- Reports dizziness and forgetfulness
Vitals:
- Orthostatic BP positive
- MMSE: borderline impairment
Student Assignment Requirements
1. Pathophysiology (25%)
- Aging physiology and medication sensitivity
- Mechanisms of orthostasis and cognitive impairment
- Fall-related morbidity
2. Geriatric Assessment (35%)
- Medication reconciliation and Beers Criteria application
- Cognitive and fall-risk evaluation
- Functional and safety assessment
3. Pharmacology & Deprescribing Plan (30%)
- Identification of high-risk medications
- Deprescribing strategy with rationale
- Non-pharmacologic interventions
4. APA & Professional Writing (10%)
RUBRIC – CASE STUDY 3 - Geriatric Falls, Polypharmacy & Cognitive Change (100 Points)
1. Aging & Pathophysiology (25 points)
|
Level |
Description |
|
Excellent (23–25) |
Demonstrates strong understanding of age-related
physiologic changes and medication sensitivity with direct application to
falls and cognition. |
|
Satisfactory (18–22) |
Correct explanation with minor gaps or limited
synthesis. |
|
Unsatisfactory (13–17) |
Partial understanding of geriatric physiology. |
|
Poor (1–12) |
Inaccurate or minimal explanation. |
|
Not Submitted (0) |
Section not submitted or missing. |
2. Geriatric Assessment & Safety (35 points)
|
Level |
Description |
|
Excellent (33–35) |
Comprehensive geriatric assessment including falls,
cognition, medications, and safety planning. |
|
Satisfactory (26–32) |
Assessment covers major areas but lacks depth or
prioritization. |
|
Unsatisfactory (18–25) |
Incomplete or fragmented assessment. |
|
Poor (1–17) |
Clinically unsafe or insufficient evaluation. |
|
Not Submitted (0) |
Section not submitted or missing. |
3. Pharmacology & Deprescribing (30 points)
|
Level |
Description |
|
Excellent (28–30) |
Identifies high-risk medications and presents a safe,
patient-centered deprescribing plan supported by evidence. |
|
Satisfactory (22–27) |
Deprescribing plan is reasonable but incomplete. |
|
Unsatisfactory (16–21) |
Limited understanding of medication risk or
deprescribing principles. |
|
Poor (1–15) |
Unsafe medication decisions. |
|
Not Submitted (0) |
Section not submitted or missing. |
4. APA & Professional Writing (10 points)
(Same descriptors as Case 1)
Submission
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