HEALTH ASSESSMENT OF ELDERLY

Introduction:-
Health assessment of elderly is very essential for rendering need based care. It implies their
detailed investigation in terms of physical, mental, social and spiritual health and wellbeing;
formal and informal social support and economic resources; physical environment; nutrition
status; life style including exercise and use of drugs including alcohol and tobacco.
The need for such comprehensive assessment arises because of potential or actual
breakdown of independent living due to aging process, vulnerability, multiple pathology,
harmful effects of drugs, inadequate or lack of social and economic support etc.

Health assessment by multidisciplinary team:-

The comprehensive assessment of elderlies requires multidisciplinary team approach because of
its complex nature. The members who can be included are:-
 Physician
 Nurse
 Social worker
 Clinical psychologist
 Nutritionist
 Phychiatrist
 Spiritual leader
 Family member and/or significant other
The composition of the team will vary according to circumstances. By and large, the team
consists of a physician, a nurse and a social worker who may not be there at some places. Other
members who may be included are a physiotherapist and an occupational therapist. Some other
members who may be involved from time to time are psychotherapist, clinical psychologist,
speech therapist and clinical specialists.

Purposes:-
The purposes of comprehensive assessment of elderlies by the multidisciplinary team are:
 to assess health and functional status
 to identify potential and actual problems
 to determine health needs and develop programme of actions to be implemented to meet
their needs.
 to identify the clinical problems.
 to assess risk of preventable disorders.
Objectives:-
The objectives of comprehensive assessment include:
 to prevent breakdown of independent living
 to deal with potential problems of breakdown for independent living
 to deal with actual breakdown (problems) of independent living
 to support and rehabilitate.

CLASSIFICATION OF ELDERLY(WHO) :

 OLDER/ ELDERLY PERSON = 60-79

 OLDEST OLD = 80-99
 CENTENARIAN = 100-109
 SUPER CENTENRIAN= 110 and above
TECHNIQUES OF DATA COLECTION: Techniques used are

 Interview
 Observation
 History taking
INSTRUMENTS USED DURING HEALTH ASSESSMENT:

 Sphygmomanometer
 Glucometer
 Thermometer
 Telequist chart
TOTAL NUMBER OF HOUSES : 100

TOTAL ELDERLY POPULATION: 50

 MALES: 31
 FEMALES: 19
 TABLE 1

Frequency and percentage distribution of elderly according to age and gender

N=50

Frequency Percentage
Gender (n) (%)
Male 31 62
 60-79 18 59
 80-99 10 32
 100-109
 110 and above 03 09
00 00

Female 19 38
 60-79 13 68
 80-99 05 26
 100-109
 110 and above 01 06
00 00

Table 1(figure 1) depicts that out of total population of elderly, 62% were males, out of them
59% were belonged to 60- 79 age group followed by 32% and 9% were belonged to age group of
80- 99 and 100- 109 respectively. On other hand among total elderly population, 38% were
females, out of them, 68% were belonged to 60- 79 age group followed by 26% and 6% were
belonged to age group of 80- 99 and 100- 109 respectively.

Table 2
 Frequency and percentage distribution of elderly population according to level of
education

N=50

Males (n=31) Females(n=19)

Educational
level Frequency (n) Percentage (%) Frequency (n) Percentage (%)
Illiterate 12 38.7 12 63.1
Primary 04 12.9 04 21.1
Middle 06 19.35 02 10.5
Secondary 03 9.6 01 5.2
education
Senior 05 16.1 00 00
secondary
Graduate 01 3..22 00 00
Post- graduate 00 00 00 00

Table 3 (figure 3) depicts that among males, 38.7% were illiterate, 19.35% had middle
secondary, 16.1% had senior secondary education, 12.9% had primary education, 9.6% had
secondary education and rest 3.22% were graduate. On other hand among females, 63.1% were
illiterate, 21.1% had primary education, 10.5% had middle education and remaining 5.2% had
senior secondary education

Table-4
 Frequency and percentage distribution of elderly population according to head to toe
assessment

N=50

MALE FEMALE
HEAD TO TOE ASSESSMENT
(%) (%)
SCALP
 Clean 43 49
 Not clean 57 51
HEAD
Dandruff
 Present 41 33
 Not present 59 67
Pediculosis
 Present 2 8
 Not present 98 92
Colour of hair
 Grey 54 23
 Black 16 10
 White 30 67
EYES
Discharge
 Present 65 65
 Not present 35 35
Conjunctiva
 Pale 3.5 13.5
 Pink 45.5 35.5
51 51
 Dry
Vision
34 12
 Normal
32 43
 Shortsightedness 45
34
 Longsightedness
Eyelashes 39 45
 Present 07 2
 Absent 34 31
 Dryness 20 22
 Sticky
MOUTH
Colour of tongue
 Pink 27 38
 Patchy tongue 54 53
 Stomatitis 19 9
 Dental caries
 Present 11 05
 Absent 89 95
Teeth
 Dentures 32 34
 Presence of teeth 12 12
 Absence of teeth 56 54
NECK
Lymph nodes
 Present 55 43
45 57
 Absent
Range of motion
65 62
 Present
35 38
 Absent
EXTREMITIES
Range of motion 59 32
 Present 41 68
 Absent
Flexion 69 32
 Present 31 68
 Absent
Extension
 Present 33 23
 Absent 67 77
SKIN
Wrinkled
 Present 82 67
 Absent 18 33
Dryness
 Present 75 80
 Absent 25 20
Thinned skin
 Present 77 82
 Absent 23 18

Table (4) depicts the head to toe examination which shows that among elderly male population
43% were having clean scalped and 57% were having not cleaned scalp.In head 41% and 2%
were having dandruff and pediculosis and remaining 59% and 98% having absence of dandruff
and pediculosis.54%,30%and 16% were having grey, white and black hair colour. 65% and 35%
were having presence of discharge and absence of discharge respectively. 45.5% were having
pink, 51% were having dry and remaining 3.5% were having pale conjunctiva. 34% were having
normal eyesight and longsightedness and remaining 32% were having shortsightedness.39%
were having eyelashes and 7% were having absence of eyelashes and 34% were having dryness
and 20% were having sticky eyelashes. 54% were having the patchy tongue,27% were having
pink colour and 19% were having the stomatities.89% were having absence of dental caries
where 11% were having presence of dental caries.56% were having absence of teeth ,32% were
wearing dentures and 12% having their own teeth.55% were having lymph nodes in neck. 65%
were having and 35% were having absence of range of motion in neck.59% were having range of
motion in extremities and 41% were having absence of range of motion in extremities.69% were
having flexion and 31% were having absence of flexion in extremities. 33% were having
extension in extremities.82% were having wrinkled skin. 75% were having dried skin and 77%
were having thinned layer of skin.

Among elderly female population 49% were having clean scalped and 51% were not having
cleaned scalp. In head 33% and 8% were having dandruff and pediculosis and remaining 67%
and 92% having absence of dandruff and pediculosis. 67%,23%and 10% were having grey, white
and black hair colour. 65% and 35% were having presence of discharge and absence of discharge
respectively. 35.5% were having pink, 51% were having dry and remaining 13.5% were having
pale conjunctiva. 12% were having normal eyesight and 45% longsightedness and remaining
43% were having shortsightedness. 45% were having eyelashes and 2% were having absence of
eyelashes and 31% were having dryness and 22% were having sticky eyelashes. 53% were
having the patchy tongue, 38% were having pink colour and 9% were having the stomatities.95%
were having absence of dental caries where 05% were having presence of dental caries.54%
were having absence of teeth ,34% were wearing dentures and 12% having their own teeth.57%
were having lymph nodes in neck. 62% and 35% were having presence and absence of range of
motion in neck respectiely.32% were having range of motion in extremities and 68% were
having absence of range of motion in extremities.68% were having flexion and 31% were having
absence of flexion in extremities. 23% were having extension in extremities.67% were having
wrinkled skin. 80% were having dried skin and 82% were having thinned layer of skin.
 Table- 3

Frequency and percentage distribution of elderly population according to current

systematic health problems

N=50

Males (n=31) Females(n=19)

Percentage (%) Percentage (%)

Health Problems

1. Nervous system
 Disorientation 28 18
14 18
 Alziemer’s disease
25 20
 Depression
12 12
 Parkinson disease
21 32
 Normal

2. Integumentary system
11 34
 Pruritis 22 26
 Redness 33 10
 Edema 02 10
 Eczema 32 20
 Normal

3. Respiratory System
 Asthma 34 23
 Common cold 26 32
 Pulmonary tuberculosis 10 33
 Normal 30 12

4. Cardiovascular system
 Hypertension 43 53
 Hypotension 27 32
11 13
 Myocardial infarction
19 02
 Normal
5. Endocrine system
 Diabetes mellitus 47 33
 Hyperthyroidism 23 33
 Hypothyroidism 10 12
 Normal 20 22

6. Gastrointestinal system
 Constipation 43 43
25 23
 Diarrhoea
09 14
 Peptic ulcer
23 20
 Normal

7. Musculoskeletal system
 Osteoporosis 43 23
 Rheumatoid arthritis 23 47
 Normal 34 30

8. Genitourinary system
 Renal calculi 23 33
 Incontinence of urine 47 47
30 20
 Normal

9. Sensory system
 Cataract 21 20
10 12
 Glaucoma
25 31
 Hearing loss
12 10
 Tactile hallucinations
04 17
 Vision loss
28 10
 Normal

Table 3 depicts the current systematic health problems of elderly population among males health
problem related to the nervous system 28% were having disorientation problem, 25% were
suffering from depression,14% were having alzeimer’s disease, 12% were having Parkinson
disease remaining 21% were having no problem related to nervous system. In integumentary
system 33% were having edema, 22% were suffering from redness over skin, 11% were having
prurities and 2% were having eczema whereas 32% of males were having no problem related to
the integumentary system. In respiratory system 34% were suffering from asthma, 26% were
having common cold problem, 10% were having pulmonary tuberculosis whereas 30% were
having no problem related to the respiratory system. In cardiovascular system 43% were
suffering from hypertension, 27% were having hypotension, 11% were having myocardial
infarction and 19% were those who having no problem related to the cardiovascular system. In
endocrine system 47% were suffering from diabetes mellitus, 23% were having hyperthyroidism
problem and 10% were having hypothyroidism and 20% were having no problem related to
endocrine system. In gastrointestinal system 43% were having constipation problem , 25% were
having diarrhea, 9% were having complain about peptic ulcer. In musculoskeletal system 43%
were having osteoporosis, 23% were having rheumatoid arthritis and 34% were having no
problem. In genitourinary system 23% were having renal calculi problem, 47% were having
incontinence of urine and 30% were having no problem related to this system. In sensory system
25% were having problem of hearing loss, 21% were having cataract, 12% were having tactile
hallucination, 10% were having glaucoma, 4% were having problem of vision loss and
remaining 28% were normal.

Among females health problem related to the nervous system 20% were suffering from
depression ,18% were having disorientation problem and disorientation respectively, 12% were
having Parkinson disease remaining 32% were having no problem related to nervous system. In
Integumentary system 34% were having prurities , 26% were suffering from redness over skin,
and 10% were having eczema and edema respectively whereas 20% of females were having no
problem related to the integumentary system. In respiratory system 33% were having pulmonary
tuberculosis, 32% were having common cold, 23% were suffering from asthma whereas 12%
were having no problem related to the respiratory system. In cardiovascular system 53% were
suffering from hypertension, 32% were having hypotension, 13% were having myocardial
infarction and 2% were those who having no problem related to the cardiovascular system. In
endocrine system 33% were suffering from diabetes mellitus and hyperthyroidism problem and
12% were having hypothyroidism and 22% were having no problem related to endocrine system.
In gastrointestinal system 43% were having constipation problem, 23% were having diarrhea,
14% were having complain about peptic ulcer. In musculoskeletal system 47% were having
rheumatoid arthritis, 23% were having osteoporosis, and 20% were having no problem. In
genitourinary system 47% were having incontinence of urine, 33% were having renal calculi
problem and 20% were having no problem related to this system. In sensory system 31% were
having problem of hearing loss, 20% were having cataract,17% were suffering from vision loss,
12% were having glaucoma, 10% were having tactile hallucination and remaining 28% were
normal.
SUBJECT: COMMUNITY HEALTH NURSING

SUBMITTED TO : Resp: Mrs Prabhjeet Kaur

(Associate Professor)

SUBMITTED BY: Navjot Kaur

Msc(N) 2nd year
Roll No:- 07

SHRI GURU RAMDASS COLLEGE OF

NURSING HOSHIARPUR
INDEX
Sr.No CONTENT Teacher signature
1 Visit report on leprosy centre
2 Visit report on senior citizen home, jalandhar
3 Pingla ghar, jalandhar
4 De- addiction centre NIMHANS, Bengalore
5 Visit report on government TB Centre,
Hoshiarpur
6 Visit report on SCMHC(Sakalawara
Community Mental Health Centre)
NIMHANS, Bangalore posting
7 Visit report on Cancer Centre, Hoshiarpur
8 Visit report on A.R.T Centre/ STD clinics
Hoshiarpur
9 Protocol for dehydreation
10 Standards for ORS preparation at home
11 Proposal for exhibition
12 Report on exhibition