INSTITUTE FOR ALGORITHMIC MEDICINE

Geriatric Functional Rating Scale (GFRS)

Purpose: To evaluate an elderly patient using the Geriatric Functional Rating Scale.

Does the patient have any dietary restrictions?	Yes No
Is the person's judgment impaired?	Yes No
Does the patient have auditory or visual hallucinations?	Yes No
Can the person read and write letters?	Yes No
Is the person able to use the telephone?	Yes No
Is the person able to bank and shop?	Yes No
Is the person able to prepare simple meals and bake?	Yes No
Can the person dress and wash self without assistance?	Yes No
Can the person use public transportation?	Yes No
Is the person able to take his or her own medications and follow a diet?	Yes No
Is the patient ethnically compatible with the community?	Yes No
Are helpful friends, relatives, neighbors, etc. available?	Yes No
Is the person able to shop at a reliable grocery that delivers when necessary?	Yes No
Is a club or center geared to the aged available?	Yes No
Is a supportive church or synagogue available?	Yes No
Is a library available?	Yes No
Are other shopping and recreational facilities available?	Yes No
Are public health nurses available?	Yes No
Are Meals-on-Wheels or similar services available?	Yes No
Are homemaker services accessible?	Yes No
Are friendly visitors available?	Yes No
Are medical facilities accessible?	Yes No
Is public transportation accessible?	Yes No
Are the person's living quarters readily accessible?	Yes No

Click the appropriate answer for each function finding

eyesight	good	can distinguish faces	sees light only or totally blind

hearing	good	can hear a loud voice	deaf

cardiopulmonary function	no restrictions	can do 1 flight of stairs	partly or totally bedridden

disorientation	none	disoriented to time	disoriented to person or place

delusions	none	suspicious	overt delusions

memory loss	none	benign	malignant

energy and drive	normal	hypoactive	hyperactive

relatives and friends	lives with an able and compatible spouse	lives with compatible relatives or friends	lives with incompatible persons

financial situation	totally independent	dependent on relatives	lives on Social Security

mobility	fully mobile	sometimes uses a cane or railing	requires a cane and other support	requires a wheelchair