GEM Screening

The Functional Screener has been specially created for older people who need to contact a healthcare facility for medical reasons. This may be an outpatient assessment, a preliminary consultation for an operation, a doctor's consultation or a visit to emergency care.

Elderly patients represent a special clientele. They have characteristics that no other patient group has, but which are similar to the care of children. They are often characterized by diffuse complaints that cannot be clearly assigned. More than 60% of them are female, tend to be socially isolated or dependent and in need of support, and have functional limitations.

Reasons for initial contact are often chronic-acute worsening symptoms, acute events such as falls, fever, weakness, confusion, helplessness, pain, inappetence, stool irregularities.

In the initial contact, it is essential to proceed in a structured manner and with the help of a scheme so that all areas are screened. The Gem Screning is based on the KLANG module, which covers all key areas such as cognition, locomotion, autonomy, nutrition and overall condition. However, the GEM Screening is not intended to provide in-depth professional training on these topics, but rather a focused examination guide that enables a complete assessment of functional symptoms in elderly patients. The procedure is structured accordingly.

The appearance and process quality of the GEM Screening should therefore exactly reflect this 5-stage workflow with logos: Data acquisition (DATA), observation (WATCH), examination (TOUCH), inquiry (ASK) and classification (CLASSIFY).


DATA: When contacting elderly patients, there is always an initial contact after data collection with name, date of birth and address.

Enter Basic Details

Gender Female Yes no
Age <85 Yes no
Urgency ASBB Yes no

WATCH: The initial contact is a wordless observation, a visual screening. All areas are observed in a structured manner, from passing on the couch, repositioning or transferring in bed, and all data is recorded. The structure is called external appearance, body, posture, vigilance.

Observe closely

External appearance Neglected, not washed or shaved, no teeth brushed or fingernails cut, no hair combed Yes no
Incorrectly buttoned, multiple garments Yes no
Leftover food on clothing Yes no
Urine/incontinence stains/odor Yes no
Body sunken eyes/ cheeks Yes no
Thin legs Yes no
Posture Crooked posture Yes no
One side of the body pushes away Yes no
Vigilance Keeps falling asleep or dozing off Yes no

TOUCH: direct contact is now made with the patient, verbal contact is made in a targeted manner and the reaction is perceived, the hand is shaken, the skin is felt, memo, abstraction, concentration, cooperation and body position changes are screened. This is followed by smiling, mouth inspection, swallowing and the memo function.

Investigate in a structured way

Verbal contact, greeting Reacts irritated, unsettled Yes no
confused, slowed down Yes no
Shake hands and squeeze firmly Weak handshake Yes no
Feel for the skin of the forearm, look standing skin folds, dry, cracked skin Yes no
Have it read (sign, name tag) Cannot read Yes no
has poor vision (even with glasses) Yes no
Query the current year/ count the months backwards/ spell the word radio backwards/ draw N+E in the air and have it repeated Cannot implement things Yes no
Does not understand what is said Yes no
Hears badly Yes no
Repeat not possible or incorrect Yes no
Weak arm Yes no
Mobility Cannot sit up independently Yes no
cannot sit/stand alone Yes no
Make you smile Assymetry of mouth Yes no
Open your mouth Dry mouth, barking, inflammation, thirst Yes no
Food residue in the mouth Yes no
Have water swallowed Must stop, clear throat, cough, salivate Yes no
Cannot continue drinking without being asked Yes no
Assistance with medical measures (RR, BE, undressing, ECG) Cannot implement things Yes no
Which letters were painted in the air No memory of letters or content Yes no

ASK: This is followed by precise questioning of secondary sources of information, as not all information is recorded or received by the patient. Ideally, these are relatives, the nursing ward or the family doctor. Specific questions are asked about mobility, nutrition, self-care, memory, mood and general data.

Additional Info

Mobility Does not leave the appartment Yes no
Does not leave the bed Yes no
Falls/ Unsteady/ transfer not possible Yes no
Nutrition Has eaten less or one sidedly Yes no
Clothing has moved on Yes no
Self- sufficiency Needs more support Yes no
Cannot bathe/ wash themselves Yes no
Cannot put on selected cloths themeselves Yes no
Memory Serious changes in memory Yes no
Changes have occured accutily Yes no
Has had memory problems for more than 6 months Yes no
Mood Has been sad a lot lately Yes no
General Changes have occurred in the last 24 hours Yes no
has been complaining of pain recently Yes no
takes more than 6 medications Yes no
has been in hospital >1 day in the last 6 months Yes no

CLASSIFY: all this information is used to make a classification. An assignment to the patient type robust, frail or dependent is made.

Assign the Patient to a type

Robust Type 1: Complete autonomy, independent, mobile and active without external assistance, compensated illnesses. Adequate use of aids, no significant pre-existing functional limitations. Yes no
Frail Type 2: Limited autonomy, the patient was already pre-frail or frail in the outpatient setting, i.e. he had limited mobility, was weak, subjectively powerless and not very active. He needed support in terms of outpatient care services. Acute functional disorders are very likely. Yes no
Dependent TYPE 3: No more autonomy, the patient is immobile, increasingly and comprehensively in need of care, often institutionalized or with round-the-clock care at home. Acute and chronic functional disorders complement each other Yes no

The matrix of results is generated from these clicked, selected fields according to the GERAMOVER LOGIC:

  • Malfunctions
  • Suspected Diagnosis
  • Recommentations

There should be a choice between different languages (German, English, French, Spanish)