Assessing the health status of older adults can be challenging for several reasons. Nurses must be familiar with normal age-related changes to distinguish them from potential health issues. They should ask specific questions about symptoms and use tests and lab values to determine if treatable conditions are present, as older adults may not report or dismiss symptoms. Presentation of illness is often nonspecific, with vague complaints or deterioration in everyday tasks rather than clear symptoms. A functional assessment measuring ability to perform self-care and social roles is important to identify areas for improvement and goals of care for older patients.
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Assessing the health status of older adults can be challenging for several reasons. Nurses must be familiar with normal age-related changes to distinguish them from potential health issues. They should ask specific questions about symptoms and use tests and lab values to determine if treatable conditions are present, as older adults may not report or dismiss symptoms. Presentation of illness is often nonspecific, with vague complaints or deterioration in everyday tasks rather than clear symptoms. A functional assessment measuring ability to perform self-care and social roles is important to identify areas for improvement and goals of care for older patients.
Assessing the health status of older adults can be challenging for several reasons. Nurses must be familiar with normal age-related changes to distinguish them from potential health issues. They should ask specific questions about symptoms and use tests and lab values to determine if treatable conditions are present, as older adults may not report or dismiss symptoms. Presentation of illness is often nonspecific, with vague complaints or deterioration in everyday tasks rather than clear symptoms. A functional assessment measuring ability to perform self-care and social roles is important to identify areas for improvement and goals of care for older patients.
Copyright:
Attribution Non-Commercial (BY-NC)
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Download as DOC, PDF, TXT or read online from Scribd
Assessing the health status of older adults can be challenging for several reasons. Nurses must be familiar with normal age-related changes to distinguish them from potential health issues. They should ask specific questions about symptoms and use tests and lab values to determine if treatable conditions are present, as older adults may not report or dismiss symptoms. Presentation of illness is often nonspecific, with vague complaints or deterioration in everyday tasks rather than clear symptoms. A functional assessment measuring ability to perform self-care and social roles is important to identify areas for improvement and goals of care for older patients.
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The Challenge of Assessing an Older Adult
For a variety of reasons, the elderly may not provide a good history or description of their health status. Be familiar with the changes brought about by the aging process in order to distinguish normal changes from pathology. Elderly frequently do not report symptoms that they feel nothing can be done about or that they dismiss as merely the normal changes of aging. They also may fear hospitalization or institutionalization. Ask specific questions about potentially important symptoms and use other sources of information, such as test or laboratory values, to determine whether any adverse health condition is present. Older adults, particularly the frail elderly, may have multiple and chronic complaints. Listen for new or changing symptoms that might indicate potentially treatable conditions. The presentation of illness in the elderly is often nonspecific. Rather than coming with specific, well-defined symptoms and signs of disease, older adults present with vague complaints or report deterioration Although majority ofin theirpeople older ability to do everyday tasks. experience important symptoms frequently, less than 1/3 consult a physician regularly!
A. The Setting
• Ensure the safety and comfort of the older person.
• Wheelchair accessible? Allow movement by those older people who use canes or walkers? • Chairs and examining table should be designed to enable older adults with limited or painful mobility to sit and arise easily. • Adequate lighting with reduced glare
B. Effective Communication
• Establish an atmosphere of trust and mutual respect with the older
person. • Explain the purpose of the evaluation, what type of questions will be asked, and what, if any, standardized or laboratory tests will be used. • Demonstrate your respect for the older person by addressing them formally as Mr. or Mrs. • Do not assume cognitive losses – Do NOT patronize!
Special Note:
Allow sufficient time to complete a comprehensive assessment.
• Geriatric histories, by virtue of the number of years they cover and the multiple interrelated problems of the elderly, are often very complex. • Information from many sources--medical charts, standardized tests, and laboratory procedures--may need to be integrated into the assessment.
C. Absence of Complaints of Typical Symptoms of Disease
• Elderly patient may not provide a good history or description of their
health status. • Nurse must be familiar with the changes brought about by the aging process so in order to distinguish normal changes from pathology. • Ask specific questions about potentially important symptoms and use other sources of information, such as test or laboratory values, to determine whether any adverse health condition is present. • Older adults, particularly the frail elderly, may have multiple and chronic complaints. Listen for new or changing symptoms that might indicate potentially treatable conditions. • Presentation of illness in the elderly is often nonspecific. Rather than coming with specific, well-defined symptoms and signs of disease, older adults present with vague complaints or report deterioration in their ability to do everyday tasks.
E. Functional Assessment
A functional assessment measures the person's ability to perform self-care and to fulfill social roles of everyday life. Functional assessment is one of the hallmarks of the geriatric assessment, distinguishing it from the evaluation of a younger person. Because many conditions affecting the elderly are chronic in nature, achieving a complete cure is often unrealistic.
• Objectives of health care are improving or maintaining the functional abilities
and the overall quality of life of the older person. • By identifying the older person's current level of functioning and determining where improvements can be made, a functional assessment enables those objectives to be achieved. • Activities of Daily Living o ADLs, (Activities of Daily Living) Personal care--feeding, being continent, transferring, toileting, dressing, and bathing. Normally, these activities are performed independently. As the frail elderly become progressively unable to do these tasks, they require more and more caregiving assistance. o IADL’s (Instrumental Activities of Daily Living) Tasks necessary for independent functioning in the community. They include cooking, cleaning, doing laundry, shopping, using the telephone and means of transportation, taking medicines, and managing money. o AADL’s (Advanced Activities of Daily Living) Social, recreational, and occupational activities that greatly affect the individual's quality of life are advanced activities of daily living (AADLs). Playing bridge, bowling, doing crafts, or volunteering for one's church or synagogue are examples of AADLs. A change in the individual's normal pattern of AADLs may be by choice or may signal a decline in health or overall functioning.
Note: ADL’s may be assessed through self-report, but may not be accurate since the older adults may tend to minimize deficits. Direct observation is the most accurate measure of functional status..
