One Cannot Escape Big Brother Essay Example for Free

One Cannot Escape Big Brother Essay In 1984, by George Orwell, society is portrayed as having lost all traces of individuality, creative thought, and love and humanity. This â€Å"Negative Utopia† depicts the possibility of the future despair of the human race whilst warning readers of the dangers of totalitarianism. The overlying mood in 1984 is the bleakness of the future of the human race. The main character though, Winston Smith, is caught in this society that is dedicated to conformity with a mind full of intelligence, individuality, and rebellious thoughts. Winston is targeted by the government from the beginning because of his continual thoughtcrime as well as his rebellious actions with Julia. However, in a society as bleak and desolate as Orwell has depicted, Winston’s actions against the Party and Big Brother were essentially futile. Throughout the novel, Winston believes that though society forces him to conform on the outside, he can still fight the system with his thoughts and by being with Julia in secret. He believes that his own individuality reveals that there is at least a small sliver of hope for humanity, but this is not so. Syme even questions Winston, How could you have a slogan like freedom is slavery when the concept of freedom has been abolished? (pg.47). There is so much moral decay within the Party, Winston is wasting his breath and energy by trying to bring down Big Brother; it is too great, and he is too small, despite how intelligent he may be. In Orwell’s fiction society, there is no hope, no potential light for the future. Society is too far gone, as shown through aspects of life such as telescreens, Hate Week, the Hate Song, and Newspeak. The government has molded the people of Oceania’s minds into the ideal citizen: unfeeling, lacking any creative thought, love, or uniqueness. The citizens who slip by and do possess these qualities will be vaporized at some point and Winston knows this throughout the novel. Yet he still believes that in some way, he may be of help to the Brotherhood, even though he is not even sure of its existence. One thing that separated the government of 1984 from any modern day government is that when someone was a traitor, or made some attempt to overthrow the government, they were not punished, but rather â€Å"cured†. In the novel, O’Brian, who is a symbol Big Brother, states, â€Å"We are not content with negative obedience, nor even with the most abject submission. When finally you surrender to us, it must be of your own free will. We do not destroy the heretic because he resists us: so long as he resists us we never destroy him. We convert him, we capture his inner mind, we reshape him. We burn all evil and all illusion out of him; we bring him over to our side, not in appearance, but genuinely, heart and soul. We make him one of ourselves before we kill him.† (pg. 318) This portrays how Big Brother essentially ensures its own success by turning their enemies into supporters of their cause rather than persecuting them. Winston had no chance to take down Big Brother because when he was caught, he would not even become a legacy, or a shining light for others to follow suit; he would become nonexistent, a changed man who would be taught to love Big Brother. By not voicing his true opinions about the Party, Winston would have continued to know the truth behind it. However, because he did, O’Brian and other Party members â€Å"cured† him, and molded his mind into what they wished it to be. By going against Big Brother, Winston became a clay mold of the ideal fascist citizen. Winston had no chance of being happy in the world set by Orwell. He was too intelligent to go through life without questioning Big Brother, and the irony exists in the fact that that was ultimately his intellectual demise. However, if Winston had just lived in acceptance of the fact that society was so horribly corrupt, and turned away from the atrocities of civilization, he would have been much better off. He would not have been tortured, he would not have had to experience the betrayal of O’Brian, and he would not have gained then lost Julia. In today’s world, it is perhaps better to have loved and lost; but in Orwell’s 1984, one never truly gained anything because Big Brother was always watching. Orwell says in the novel, â€Å"If you want a picture of the future, imagine a boot stamping on a human face—forever† (pg 271). No amount of rebellion could possibly stop this metaphorical boot from crushing humanity. Winston could have saved himself from a lifetime of even more hurt and despair if he had just kept to himself and turned away from the evils of Big Brother. After all, the slogan â€Å"Big Brother is watching you† (pg 2) was not just a saying for the people of Oceania: it was a sad truth. Thus, Winston would have been much more fortunate given the circumstances if he had not gone against the Party.

Psychological Perspectives in Health and Social Care

Psychological Perspectives in Health and Social Care Behaviourist theories might say Katya has turned out the way she has due to the way she has been treated by her father. Katya did not get the love or attention she needed as a child, and because of this when her father sexually abused her, she saw it as a reward by showing her love. Her father also had a drug problem, and as a reward could have possibly given them to her, and is why she deals class A drugs. Ivan Pavlov, a Russian psychologist came up with the classical conditioning theory. This involves putting an unconditioned response with a conditioned stimulus, which is the new learnt behaviour from putting the response and stimulus together. As Katya has been sexually abused at such a young age, she thinks that being sexually active is a normal thing to do at her age. This possibly has lead her to become a prostitute, which is extremely dangerous fro a girl of her age, due to catching STDs and not knowing the people she is sleeping with. Katya has never gone past the psychosexual stage of the 3-5 year olds. This is when children start to realise about sex. During peoples life stages, there are different psychosexual stages they go through. If they dont go through those stages, problems will occur in a change in personality. Sigmund Freud came up with this theory. He believed the mind can be divided into 2 main parts; the conscious mind, which is everything we are aware of, and memory is a part of this as we can retrieve information once it is made aware of again. This is also known as the preconscious mind is unpleasant, such as feelings, thoughts, urges. Most of the unconscious mind is unpleasant, such as feeling of pai n, conflict, anxiety. It influences behaviour even though we are unaware of it. Erik Erikson agreed with Freuds theory, but Erikson also believed that we move through a series of psychosocial crises with a different social focus at each stage, e.g. between the age of 0-1 the life crisis concerns developing thrust or mistrust in self or others. The social focus in this stage is the mother. The biological approach can make us understand how Katya has developed due to the environment she has been brought up in, (nurture) and her genes/behaviour (nature). Nature may have made Katya the way she is from the genes that have been passed on to her. Therefore, Katya may have got her fathers tendencies towards drinking and drug taking. Arnold Gesell (1880-1961) believed children went through development norms, which meant at a certain age they should be able to learn and understand certain things. Nurture could have influenced the way Katya behaves, as she does not really understand about certain things in life from not being told by role models, e.g. father, and does not know what her boundaries are. She also has not had any proper love, so that has leaded her to do other things, and from seeing what her father does, influences her to do things she should not. Task 2 The Social Learning Theory was developed by an American psychologist called Albert Bandura. He recognised that we learn things by observing people, also known as observational learning. Katyas assessment will be based on the impact in has on her life. Katyas emotional development has been because of seeing what her father has done to her as a child. Her father has been violent, and has locked her in the bathroom, so has not had good visible care, and does not understand how important it is and reacts against what people see. This is because she has seen her father act in this way and has copied him, as she sees him as a role model. For Katyas care plan, it would involve looking at different role models, as it can affect behaviour, as shown by Katya. In health and social care provisions, in order to promote anti-discrimination practices and behaviour, messages must be put forward which maximise attention. This can be done by using positive images, for example, people we admire like celebrities with messages which help promote anti discriminatory behaviour, so we copy what they do. The humanistic approach focuses on the idea of free will and the belief that we are capable of making choices. The 2 psychologists that approached this theory were Carl Rogers and Abraham Maslow. Abraham Maslow believed that every human being require certain basic needs before they can approach the next level. This can be shown on the hierarchy of needs. Firstly, basic physical needs have to be met before progressing further, for example, food and water, well housed, and once those have been met, we then focus on our emotional needs. These are things such as feeling loved, high self-esteem and feeling or belong. Once all the needs are met, we strive to self actualise, which means reaching full potential in life. Carl Rogers was more interested in the concept of self. This is how we view ourselves. If children get praised, encouraged to succeed, and told they are valued, their self-concept will be positive and see themselves as someone who is worthwhile and competent. If they are told they are naughty or no good, it will have a negative affect and will affect part of their self-concept aspects. For Kaytas assessment, the humanistic approach can be applied on how it affects her life. Katya got treated badly as a child, making her feel not wanted by her father and un-loved. He would often shout violently at her, and if she cried or complained, and once Katyas father calmed down he would sexually abuse them. This will affect her self-concept as she has not been valued enough, and also it has affected her self-esteem as she has not had the love from others and does not know how to look after her appearance due to not being taught. On Maslows hierarchy of needs, Katya has not been able to progress further from the basic physical needs. This is because she has not been cared from properly, and is unable to move to the safety and security needs due to her father not being there for her. The humanistic approach can be applied for to health and social care provisions to help the problem. Unconditioned positive regard refers to a totally judgemental way of being with or viewing a client. The therapist supports clients feelings, beliefs and emotions un-conditioning. This means without judging whether their emotions are good or bad. Empathy is also used in helping others. It requires care workers to listen to clients, and respect them for whom they are and any emotions they have had to deal with. Jean Piaget came up with the cognitive theory, saying that cognition develops through a series of stages building on the previous stage, and so on. He believed we can only achieve certain things in certain stages in life, for example, a baby is only able to experience the world through sense perceptions (smell, touch, sight) and motor activity. This will then develop into the next stage which involves language, memory and thought and so on. For Katyas assessment, this theory has an impact on her life as she grew up to fast. This means that she has to cope with things at a certain age which her brain could not deal with. Am example of this would be her fathers behaviour towards Katya, not allowed to have any creative play by making things or decorating a dolls face and playing with its hair. In health and social care provisions, keeping a diary or record of negative thoughts and feelings can help to identify why they are feeling like the way they are. By identifying why they are feeling like that, care workers can help support the individuals through their problem. Task 3 The psychological perspectives I have chosen to analyse are the behavioural theory, biological theory and social learning theory. I have chosen these theories because they apply more for the way Katya is behaving. Psychological Perspectives Katyas Challenging Behaviour Behaviourist Theory Ivan Pavlov-reward good behaviour Ignore her bad behaviour that she shows. Is used to being rewarded for bad behaviour so when shouts and screams walk away. Make sticker reward chart, so when Katya shows good behaviour gets a sticker and when completes chart gets a reward, e.g. money. Biological Theory Arnold Gesell Nature/Nurture Katya may possibly be more sensitive to drugs because if her mum took drugs whilst she was pregnant with Katya, she may have been born a crack baby Could put Katya into rehab to get her weaned of the drugs and alcohol. Social Learning Theory Albert Bandura Observational Learning Remove or separate Katya away from those who are a bad influence towards her, e.g. father. This is the responsibility of a social worker. Arrange for Katya to see/meet a person who experienced and went through the same issues as her, and speak to her about how they have dealt with it and how they have turned out today- can be seen as a role model for Katya to help her deal with the problem she went through Health and Social care organisations can help Katyas behaviour through different types of therapies. The therapies that will help Katya come under the Psychodynamic theory (child psychotherapist), humanistic theory (child therapist), and cognitive theory (CBT-cognitive behavioural therapy). Psychological Therapies How it will help Katya Psychodynamic theory Child psychotherapist Help her to manage her difficulties with behaviour Help Katya develop new skills Help resolve her issue that she has dealt with Boost communication skills Lets her play and do activities and then once comfortable help her problems Humanistic theory Child Therapist Form strong relationships with the therapist- mode of communication and type of relationship facilitates change and growth in children experiencing emotional distress http://www.bapt.info/playtherapycareers.htm Cognitive Theory CBT Helps Katya make sense of overwhelming problems by breaking them down into smaller parts Focuses on the cause of her distress or symptoms in the past, it looks for ways to improve her state of mind now. Identify Katyas individual patterns of thoughts, emotions, bodily feelings and actions and keep a diary record Help Katya to work out how to change her unhelpful thoughts and behaviours Helps Katya to replace unhappy thoughts with positive thoughts

Research methods Essay -- essays research papers fc

Research method To gain my secondary information I used such sources as the Internet, books and midwifery journals. My secondary information will consist of the benefits of breast-feeding for the mother and baby, the benefits of bottle-feeding for the mother and baby as well as statistics on breast-feeding. All information that I have gained for my secondary data is all reliable, because it has come from recommended sites, books and journals that have been approved from the Government or from hospitals and doctors themselves. There are many research methods used to gain information, but it is important to use the right one to ensure that you get the best results possible. One method that is used is experiment; this is where you play an active part in an experiment over a period of time. The advantages of this are that it is a powerful research method and that it establishes a cause and an effect and it can be replicated easily. The disadvantages are that it can take a lot of time, it is difficult to find willing participants and there is a bigger risk of human error. I chose not to use this as my research method, because to do an experiment to would take anything from 2-6 months, which is time I do not have. It could also be classed as being intrusive watching a mother breast feed, which may be a big ethical problem, and because of that it will be hard to find willing participants. Another method of research is direct observation; this is where you are in a setting and you observe what is going on and you do not partake init. There are many good advantages to direct observing, such as, it enables you to see and hear everything that is going on, it can be easy to record, and you do not have a physical effect on the observation. The disadvantages are it can be very time consuming, your presence may have a physiological effect on the people/person being observed and you do not get reliable information. It is hard to get valid results because it is hard to replicate and different people may interrupt things differently to yourself. I did not chose this method because it would be hard and time consuming to get people’s permission to observe them this may be due to ethical issues surrounding my chosen topic. People may feel it is wrong to observe a mother breast-feeding her baby. Participant observation is another of the research methods used, this is where you... ...tionnaires will be left on show at the entrance of the ward for people to pick up. A box will be left in the staff room where the finished questionnaires will be kept until I pick them up. Hopefully by handing out questionnaires and leaving them for people to take I will get a big response rate and it will be very generalised. While conducting my research I will have to consider certain ethical issues, such as confidentiality. Every questionnaire will have a note highlighted on it explaining that every questionnaire that is filled in is kept completely confidential, hopefully by stating this fact it will reassure people to fill one in. I also have to be sensitive to people’s feelings and beliefs, and to ensure that I do not offend anyone. I will have to show that I understand that my topic area can be a sensitive topic for people to talk about or read about, I can do this by not forcing people to do my questionnaire if they feel it is not something they want to participate in. It is important that I stay non-judgemental, as this may affect people’s answers or may affect the participation Bibliography Aspects of reserach, S.D Smith, 2003, Pecan How to!, K.T Haper, 2000, Lonsdale

Students with Learning Disabilities Offered Success in College :: School Education Essays

Students with Learning Disabilities Offered Success in College Registering for college courses can be straining for even the most organized college student. Knowing which courses to take, and what order to take them in, can be more than confusing to the already over-stressed student body. This process is even more strenuous for students with learning disabilities. Registering for classes is just the beginning for learning disabled students. Kyle Turin, a freshman with Dyslexia, at Northeastern University is dismayed at the lack of attention he feels he is getting. Turin was diagnosed at a young age. He was never officially tested for a learning disability, but he was put into a specialized reading class until he went to high school. Kyle learned how to compensate for his difficulties but felt he slipped through the cracks in the system. â€Å"They (teachers) figured out in like sixth grade that I had missed a crucial part of my reading comprehension stuff that other kids did get. I was put into reading courses. But now that I’m in college, I’ll have a class of like 150 kids where the only basis of the class is the textbook and in-class lectures, so I don’t have the opportunity to compensate in class the way that I used to.† said Turin. Kyle Turin transferred to Northeastern University after his first semester at Hudson Valley Community College. â€Å"They asked me if I had Northeastern insurance, and I said no and they basically said I was out of luck. They said I had to contact my own insurance company and see if they covered the disability test that I would need in order to get extra attention through Northeastern. But my insurance company won’t cover it because I’m over 18 years old. † A learning disability is defined as any one of various conditions that interfere with an individual's ability to learn, resulting in impaired functioning in language, reasoning, or academic skills. The National Center for Learning Disabilities explains it as a neurological disorder that affects the brain’s ability to receive process, store and respond to information. Basically, among people with learning disabilities there is a noticeable gap between their level of expected achievement and their actual achievement. Doctors and professionals agree there is no way to pin-point any specific causes for learning disabilities. The NCLD says some possible causes may include heredity, problems during pregnancy or birth, head injuries or nutritional deprivation after birth, and exposure to toxic substances.

A Comparison of Bless Me Ultima and The House on Mango Street Essay

Exploring Syncretism in Bless Me Ultima and The House on Mango Street      Ã‚  Ã‚  Ã‚  Ã‚   Syncretism is the fine line between Christianity and Native American Religions because it is the ambivalent, simultaneous attraction of choice and identification to the influences of two or more religious belief systems. Syncretism is most common among minority groups such as Hispanics. The definition applied to their unique position of culture is brought about by the Native American and Spanish ancestry. Ambivalence is shown even by the word Hispanic, which is an "umbrella" term. The novels, Rudolfo Anaya's Bless Me Ultima(1972) and Sandra Cisneros' The House on Mango Street(1984) explore syncretism and how it enhances and exemplifies the issue of ambivalent behavior in regards to the combined use of Native and Christian religions. In Bless Me Ultima and The House on Mango Street, syncretism is displayed through the actions of both novels to show that syncretism is the "bridge" of ambivalence. Syncretism in context of Anaya and Cisneros' novels, merge Christianity and Native American pagan religions to form the syncretic nature of ambivalent Hispanic Americans. There are several main points in each text that exhibit the issue of syncretism. These points or issues include the "Christ-like" comparison, the witchcraft comparison, and the comparison of pagan religions of superstition and sorcery. The concept of good and evil revealed in the two Hispanic novels through the mixture of Christianity and Native religions is a type of syncretism created by folk Catholicism. According to Ellwin Stoddard's Mexican Americans, the concept of folk Catholicism, "is driven on the idea that the formal sphere of the Catholic church is blended with the Native ... ...on, folk Catholicism. In consequence, Hispanics have in a sense walked a fine line of ambivalence in relation to syncretic religious practices. Works Cited Anaya, Rudolfo. Bless Me Ultima. New York: Warner Books, 2002. Cisneros, Sandra. The House on Mango Street. New York: Random House, 2006. Dictionary of Hispanic Biography. "Rudolfo Anaya" Boston: Houghton Mifflin, 1990. Penguin Dictionary of Religions, ed. John R. Hiumells. 2004. Stoddard, Ellwin R. Mexican Americans. New York: Random House, 1973. The Heath Anthology of American Literature. 3rd.ed., v.1. "The History of the Miraculous Apparition of the Virgin of Guadalupe in 1531.Ed. Paul Lauter. Boston: Houghton Mifflin, 1998. Wiget, Andrew O., "Native American Oral Narrative" in The Heath Anthology of American Literature 3rd ed., v.1. Boston: Houghton Mifflin, 1998. 24-27.    A Comparison of Bless Me Ultima and The House on Mango Street Essay Exploring Syncretism in Bless Me Ultima and The House on Mango Street      Ã‚  Ã‚  Ã‚  Ã‚   Syncretism is the fine line between Christianity and Native American Religions because it is the ambivalent, simultaneous attraction of choice and identification to the influences of two or more religious belief systems. Syncretism is most common among minority groups such as Hispanics. The definition applied to their unique position of culture is brought about by the Native American and Spanish ancestry. Ambivalence is shown even by the word Hispanic, which is an "umbrella" term. The novels, Rudolfo Anaya's Bless Me Ultima(1972) and Sandra Cisneros' The House on Mango Street(1984) explore syncretism and how it enhances and exemplifies the issue of ambivalent behavior in regards to the combined use of Native and Christian religions. In Bless Me Ultima and The House on Mango Street, syncretism is displayed through the actions of both novels to show that syncretism is the "bridge" of ambivalence. Syncretism in context of Anaya and Cisneros' novels, merge Christianity and Native American pagan religions to form the syncretic nature of ambivalent Hispanic Americans. There are several main points in each text that exhibit the issue of syncretism. These points or issues include the "Christ-like" comparison, the witchcraft comparison, and the comparison of pagan religions of superstition and sorcery. The concept of good and evil revealed in the two Hispanic novels through the mixture of Christianity and Native religions is a type of syncretism created by folk Catholicism. According to Ellwin Stoddard's Mexican Americans, the concept of folk Catholicism, "is driven on the idea that the formal sphere of the Catholic church is blended with the Native ... ...on, folk Catholicism. In consequence, Hispanics have in a sense walked a fine line of ambivalence in relation to syncretic religious practices. Works Cited Anaya, Rudolfo. Bless Me Ultima. New York: Warner Books, 2002. Cisneros, Sandra. The House on Mango Street. New York: Random House, 2006. Dictionary of Hispanic Biography. "Rudolfo Anaya" Boston: Houghton Mifflin, 1990. Penguin Dictionary of Religions, ed. John R. Hiumells. 2004. Stoddard, Ellwin R. Mexican Americans. New York: Random House, 1973. The Heath Anthology of American Literature. 3rd.ed., v.1. "The History of the Miraculous Apparition of the Virgin of Guadalupe in 1531.Ed. Paul Lauter. Boston: Houghton Mifflin, 1998. Wiget, Andrew O., "Native American Oral Narrative" in The Heath Anthology of American Literature 3rd ed., v.1. Boston: Houghton Mifflin, 1998. 24-27.   

Incorrigible Children Book Essay

In the beginning of the book, the main characters start to make progress towards their goals. When Alexander is trying to learn his name the closest he can come to is â€Å"Loyally† (55). Even if Alexander did not get his name correct, I?s hard to pronounce his name. Alexander hard work may have not gotten him to his goal, but it was an improvement from howling. After a long day of working on not chasing squirrels, â€Å"The children would quiver and tremble†¦ But they were soon able to resist actually chasing the squirrels for whole minutes at a time† (89). All the children tried very hard.Along with the children's hard work they improved on kicking their squirrel chasing habits. The beginning of the book, the main character goals are becoming slightly closer As the book progresses the main characters determination has started to pay off. Lady Constance was somewhat pleased when Penelope told her the children†Ã¢â‚¬ ¦ Have learned the words for many common it ems, such as ball, doily and so forth† (70). Lady Constance is seeing improvements in the children because of Penelope' work toward the kids. If it wasn't for Pongee's interest in the kids there would be no improvement in their education.The kids not know enough words to be creative and recite a poem that goes, â€Å"Moon, moon, moon. Night, no moon? Dark. Night, yes moon? Light! Yes, moon! Ahwooooo† (92). Penelope is thrilled to know that the poetry she has read the children has inspired them to creativity is proving that the kids are starting to live normal-sis lives. As the book progresses what the main characters have done is starting help them. At the end of the book the main characters realize that hard work really does pay off. â€Å"Alexander. Please to make your acquaintance† (193).Alexander has earned to talk and is greeting guests at the Lady and Lord's Christmas party. At the beginning of the book, Alexander could not talk at all. In the beginning of the book progress is made to completing the goals Penelope has set for the children. Later on in the story some of the smaller goals have been met in civilizing the children. Finally at the end of the book, all of the hard work paid off and the children have taken the first step to becoming more like normal children. Mayors Wood used her book, The Incorrigible Children of Gaston Place, to show the readers that if you try hard, you will never fail.

Comprehensive Geriatric Assessment Essay

The geriatric assessment is a multidimensional, multidisciplinary diagnostic instrument designed to collect data on the medical, psychosocial and functional capabilities and limitations of elderly patients. Various geriatric practitioners use the information generated to develop treatment and long-term follow-up plans, arrange for primary care and rehabilitative services, organize and facilitate the intricate process of case management, determine long-term care requirements and optimal placement, and make the best use of health care resources. The geriatric assessment differs from a standard medical evaluation in three general ways: (1) it focuses on elderly individuals with complex problems, (2) it emphasizes functional status and quality of life, and (3) it frequently takes advantage of an interdisciplinary team of providers. Whereas the standard medical evaluation works reasonably well in most other populations, it tends to miss some of the most prevalent problems faced by the elder patient. These challenges, often referred to as the â€Å"Five I’s of Geriatrics†, include intellectual impairment, immobility, instability, incontinence and iatrogenic disorders. The geriatric assessment effectively addresses these and many other areas of geriatric care that are crucial to the successful treatment and prevention of disease and disability in older people. Performing a comprehensive assessment is an ambitious undertaking. Below is a list of the areas geriatric providers may choose to assess: †¢ Current symptoms and illnesses and their functional impact. †¢ Current medications, their indications and effects. †¢ Relevant past illnesses. †¢ Recent and impending life changes. †¢ Objective measure of overall personal and social functionality. †¢ Current and future living environment and its appropriateness to function and prognosis. †¢ Family situation and availability. †¢ Current caregiver network including its deficiencies and potential. †¢ Objective measure of cognitive status. †¢ Objective assessment of mobility and balance. †¢ Rehabilitative status and prognosis if ill or disabled. †¢ Current emotional health and substance abuse. †¢ Nutritional status and needs. †¢ Disease risk factors, screening status, and health promotion activities. †¢ Services required and received. The primary care physician or community health worker usually initiates an assessment when he or she detects a potential problem. Like any effective medical evaluation, the geriatric assessment needs to be sufficiently flexible in scope and adaptable in content to serve a wide range of patients. A complete geriatric assessment, performed by multiple personnel over many encounters, is best suited for elders with multiple medical problems and significant functional limitations. Ideally, under these circumstances, an interdisciplinary team — representing medicine, psychiatry, social work, nutrition, physical and occupational therapy and others — performs a detailed assessment, analyzes the information, devises an intervention strategy, initiates treatment, and follows-up on the patient’s progress. Due to the intricate nature of comprehensive assessments, many teams designate a case-manager or caseworker to coordinate the entire effort. Most assessments take place in medical offices and inpatient units over multiple visits. If at all possible, however, at least one member of the team (rarely the physician) will attempt to visit the patient at home. Despite the problem of low or no reimbursement, the typically high-yield of information from even a single home visit makes it an extremely efficient use of resources. Most geriatric assessments, performed under the constraints of time and money, tend to be less comprehensive and more directed. Although such modifications are best suited to relatively high-functioning elders living in the community, many practitioners find some version of a directed geriatric assessment to be a more realistic tool in a busy practice. Patient-driven assessment instruments are also popular among geriatricians. Asking patients to complete questionnaires and perform specific tasks not  only saves time, but also it provides useful insight into their motivation and cognitive ability. To the extent that patients are unable to complete the assessment themselves, practitioners resort to traditional patient interview techniques that frequently involve input from a family member or other caregiver. During your upcoming site visits, you will perform a directed geriatric assessment (DGA), ideally with the same patient, over two sessions. In the interest of education, most of your DGA instruments are student-driven, rather than patient-driven, and require relatively little information from caregivers who may or may not be available at the time of your visit. We have divided the DGA in two parts, each with three subsections. In Part I, you will perform an expanded medical interview covering the clinical history, nutritional assessment and a social evaluation. In Part II, you will perform neuropsychiatric, physical and functional examinations. What follows is a reproduction of the History and Physical (H&P) format that you will use in your Physical Diagnosis II course next semester. Although all geriatric practitioners do not use a standard assessment format (comprehensive or otherwise), most agree on basic content. The comprehensive geriatric assessment (history & examination) following the Physical Diagnosis outline covers the most significant content areas of a prototypical geriatric assessment. As you can see, it moves well beyond the standard H&P, which is precisely the point. We have designed it to correlate as closely as possible with the history and physical you will be learning later this year. It is to your considerable advantage to review this information before meeting your patients face-to-face on the site visits. The DGA instrument you will use during your encounter immediately follows this section.