Table 2.
ICEBERG tool (score range 1 to 30).
| ICEBERG questionnaire answers (score) |
Score |
|---|---|
|
Q1: Where does the patient live? □ Living independently at home without support (0) □ At home with support from family member and/or outside help (eg SPITEX) (2) □ In a nursing home (3) |
|
|
Q2: What is the patient's age? □ 70-79 years (1) □ ≥ 80 years (2) |
|
|
Q3a: Falls (2+) in the last 12 months? □ Yes (3) □ No (0) Q3b: Is a fall the reason for the current ER visit? □ Yes (1) □ No (0) |
|
|
Q4a: Is there any sign for a cognitive disorder impacting everyday life activities? □ Yes (3) □ No (0) Q4b: Has the patient felt down, depressed, or fatigued lately? □ Yes (2) □ No (0) |
|
|
Q5: Can the patient count the months of the year backwards without ANY ERROR up to and including September? □ Yes (0) □ No (3) |
|
|
Q6a: ER or emergency visit at GP in past month? □ Yes (2) □ No (0) Q6b: Hospitalization in past 6 months? □ Yes (2) □ No (0) |
|
|
Q7: How many drugs does the patient take regularly? □ Between 0 and 3 drugs (0) □ Between 4 and 7 drugs (1) □ ≥ 8 drugs (2) |
|
|
Q8a: Does the patient usually need any help with taking showers or bathing? □ Yes (2) □ No (0) Q8b: Right now, can the patient transfer from a lying or sitting position to a standing position independently? □ Yes (0) □ No (2) |
|
|
Q9a: Has the patient lost more than 3 kg weight without trying and/or do the clothes not fit anymore? □ Yes (2) □ No (0) Q9b: Has the patient been eating poorly because of decreased appetite? □ Yes (1) □ No (0) |