Question

What does a pattern of findings provide the nurse in assessment of a patient’s functioning, using the Global Assessment of Functioning (GAF)?

Answer 1

Global Assessment of Functioning :

A global assessment of function, known as a GAF, is commonly used in the Social Security Administration to determine mental status. An individual with a GAF score of between 51 and 60 may experience moderate symptoms as well as difficulty functioning in social environments.

Scoring system:

The scores range from 0 to 100, with 100 representing superior functioning. Doctors take into consideration how much difficulty a person has in their daily life with social, occupational, school, and psychological functioning before assigning a score.

Criteria used to give GAF Score :

There are two main categories of consideration.

(i) The first is a person’s level of functioning in daily life.

(ii) The second is the severity of their mental illness.

Doctors can determine a person’s GAF score using several items of information, including:

1) talking to the person

2) interviewing the person’s family members or caretakers

3) reviewing the person’s medical records

4) reviewing a person’s police or court records detailing their behavioral history

Once a doctor reviews this information, they review the GAF scoring ranges. While the scores may be numeric, the scoring is still subjective. This means two doctors could possibly assign a person two different GAF scores. However, this ideally this wouldn’t happen.

Different scores and examples:

*) 100 to 91. Superior functioning with no symptoms that impair functioning.

*) 90 to 81. Absent minimal symptoms, such as anxiety before an exam.

*) 80 to 71. Slight impairment in work or school with occasional symptoms that are expected reactions to psychological stressors.

*) 70 to 61. Mild symptoms, such as mild insomnia or depressed mood or some difficulty in social, occupational, or home situations.

*) 60 to 51. Moderate symptoms, such as occasional panic attacks, or some difficulty in building meaningful social relationships.

*) 50 to 41. Serious symptoms, such as suicidal thoughts or severe, obsessive rituals. The person could also have severe impairment in work, such as being unable to keep a job.

*) 40 to 31. Some impairment in communication, psychosis (loss of touch with reality) or both, or major impairment in school, work, family life, judgment, thinking, or mood.

*) 30 to 21. A person experiences frequent delusions or hallucinations or features severely impaired communication or judgment. They’re unable to function in almost all areas, such as staying in bed all day, and have no meaningful relationships.

*) 20 to 11. A person is in danger of hurting themselves or others. They may have made suicide attempts, display frequent violent behaviors, or have major impairment in communication, such as muteness or speaking incoherently.

*)10 to 1. A person is in almost constant danger of hurting themselves or others, has made a serious suicidal act with clear expectation of death, or both.

*) 0. There’s inadequate information to assess the person.

Uses and Applications :

When a person’s mental illness makes it difficult to function in their everyday life, they need help. This could include counseling services or around the clock medical care. Doctors use a GAF score to determine how much help a person may need due to their illness.

Because the GAF system uses a standard set of criteria, one doctor can tell another doctor a person’s GAF score and they immediately have an idea of how a person’s illness affects them.