A case taking primer for your geriatric patient:
4. Marital status
5. Postal address
7. Chief complaints
a. What is your suffering/ difficulty at present
b. How long are you suffering? Is there any particular cause for the
beginning of your complaint?
c. When do you feel better/ what do you do to get relief from your complaint?
d. When does your condition get worse?
e. Do you have any associated complaint with your presenting complaint?
8. If the case is already diagnosed then diagnosis of the case? Who
diagnosed the case?
9. If investigation done reports of investigation (with date).
10. Under any medication, if yes specify treatment and medicine name.
11. Present History (Whether patient is suffering from any diseases
like Arthritis, blood pressure, Diabetes, HIV, Tuberculosis or Cancer)
specify since when?
12. Past History (Any diseases which occurred in the past
Tuberculosis, hepatitis, typhoid, etc any others specify when. If
patient has undergone any surgical intervention for what and when.)?
13. Family History (Family history of any disease)?
a. Whether father and mother alive? (or Died at the age of……………)
b. If yes do they suffer from illness, If no how did they die?
c. How many brothers and sisters do you have, do they have any illness?
d. Are there any hereditary diseases in your family?
14. Craving for food or drinks specify.
15. Aversion to any food items?
16. Intolerance for any food item?
17. Aggravation from any food item?
19. About your perspiration (Is it decreased, increased or no
perspiration or any color or odor, any staining, etc)
20. Urine (Any color change or any difficulty in urination)
21. Bowel motion (No of times/ day or any other ailment regarding bowel motion)
22. If any climate you prefer specify
23. Any addiction to alcohol, smocking, chewing, drugs, etc
24. Menstrual flow (How many days, presence of clot or any abnormal discharge)
25. About fertility, if any problems
a. How many times did you become pregnant?
b. Did you have any abortions? (Give details)
c. Did you suffer from any disease during pregnancy?
d. Was your pregnancy normal of cesarean session? If cesarean what was the reason?
26. Sexual relations and problem of sex during fertile period/now.
a. Do you have any difficulty in sex?
b. Do you have any premarital or extra marital relation?
27. Any peculiarities about your dreams
28. If your complaint occur in any one side of the body?
29. Do you feel warmer or colder than others? If yes please explain
a. Response to fanning, bathing, climate, open air, etc?
30. Any peculiarities about your sleep?
31. Are you working now.
32. If you are retired from any job how many years back.
33. What difference do you feel in your retirement life?
34. Are you financially independent.
35. How many children Do you have.
36. Are your children are employed?
37. Are your children are staying with you or away from home.
38. How is your relation with your children?
39. Are you financially independent ?
40. How frequent you are get acquainted with your grandchildren.
41. Mental features including attitude, fear, anxieties, other thoughts etc.
a. Any depression, disappointment or sadness which is deep rooted in
the mind for very long time after which the presenting complaints
b. Do you prefer company/ prefer sit alone and be to yourself?
c. How close you are to your family and friends, do you like being with them?
d. How do you see your future? (Optimistic / pessimistic, any suicidal
e. How sensitive are you? Do you weep immediately if anyone hurts you
or get angry/ irritated?
f. How do you react when person insults you?
g. Reaction to silly matters? (Easily angered / Easily weeping, etc.)
h. Do you have jealousy if anyone gets the thing/achieve anything
which you wanted/ how do you feel?
i. Do you compel everyone to listen to you/ believe that you are
right? Do you feel irritated if anyone doesn’t listen to your words/
j. How do you respond to injustice?
k. Are you courageous? Do you want people always with you when you go out?
l. Do you have any fear to public performance (stage fright)/ crowded
places (festivals, parties/ ceremonies)/ higher altitude/ open places/ narrow places/ loneliness/ darkness/ diseases/ dirt/ infection/ strangers/ death/ opposite sex/ thunderstorm/ lightning/ evil spirits/ animals/ robbers/ etc.,) explain?
m. Any mental confusion at work/ doing any calculation?
n. How is your memory?
o. Concentration in work?
p. Do you make mistakes while writing, reading, speaking / while doing
q. Any anxiety about your health or others health?
r. Do you like traveling, music?
s. How do you react when a person talks against your ideas/ views?
t. What do you do in your spare time?
Dr. Biju G Nair