Ateneo de Zamboanga University

College of Nursing

NCM 114j

Care of the Older Adults

Geriatric Assessment

Name : Score
Section :

Instruction: Assess an older Adult age 60 and above. It maybe your grandparents , or a family
member, or an elder in the neighborhood.. base on the assessment guide below in term of
History, Physiologic , Functional level be it ADL or IADL and Depression Scale . From the
Assessment below Write at least five (5) Nursing Diagnosis and Five health Teachings ton keep
the older person maintain a satisfactory and Happy life.

Patient Name : N. S. C.
Age : 68years old
Ethnic : Bisaya
Religion : Catholic
Marital Statius : Married
Educational Attainment: High school graduate
Support System : Family
Source of Income : SSS Pension, Family support

GERIATRIC ASSESSMENT
History
•Present medical History- Anemia
a. Medical History •Past medical – Hospitalized due to Typhoid Fever
•Surgeries - none
a. Drug History •Medications: Iron supplementation, Ferrous sulfate and B12
supplementation.
•Tobacco alcohol: Don’t have any form of vices
b. Nutrition History •Type of diet: eating vegetables, fruits, fish and avoiding foods
high in cholesterol.

•Weight: 48 kgs.
•No problems in chewing
•Taste: Able to taste sweet, bitter, sour and salty

Geriatric Assessment Workshop D.I. Halbi


c. Mental Health
d. Social History
Vital Signs
Integumentary
Sensory function
Respiratory Function
Circulatory Function
Gastrointestinal Function
Genito urinary function
Musculoskeletal function
Geriatric Assessment Workshop
•Smell: Able to smell good and foul smell
•Able to sleep on time for at least 7 hours and wake up early
•Easy to get nervous
•Sometimes hard to recognize things and memories.
•Living arrangements: Living with her daughters
•financial status: Stable
•Hobbies: Reading books, watching TV and do household chores
•Socialization: Like to stay at home than meeting people
•Support system: Family
Assessment- Physical Examination
T: 37.3°C
PR: 110 bpm
RR: 20 bpm
BP: 100/70 mmHg
•Texture: Dry, thin and pale
•Turgor: elastic
•Skin problems: None
•Skin Injury: None
•Color hydration: Brown
•Nails: Dry
•Hair: Dry and color silver hair
•Head and neck: Presence of wrinkles and drooping skin
•Hearing: Normal
•Vision: With Reading glasses 100/80
•Touch: Able to feel the sensation of tingling sensation in joints
•Taste: Able to taste sweet, sour, salty and bitter
•Smell: Able to smell sweet and foul
• often experience difficulty of breathing
• Don’t smoke, take alcohol or drugs
• Chest sound: Vesicular
• Chest size: Symmetrical
• Xray: No scoliosis noted
•Chest pain: present
•Fatigue: Sometimes after doing light exercise
•ECG: Never try
•Oral health assessment: With full dentures, gums, buccal
mucosa and tongue is pink in color
•Oral health practice:brushing teeth after meal
•Appetite: Decreased in appetite
•Nausea and vomiting: absent
•Stomach discomfort: present
•Bowel elimination: Frequent constipation
•No urinary problems
•Urinary frequency: 6 times a day
•Posture and walking: Straight
•Gait: Independent Endomorphic
D.I. Halbi
 •Arthritis: present in knee and lower back
•Muscle strength: Decrease
Reproductive Function •no abnormal bleeding or discharges and she is menopause.
Neurological Symptoms •Sleeping at least 7 hours per night
•All of the 5 senses are still in active and normal ways
•Memory: Tend to forget things and memories
•Able to feel pain and burning sensation
•Motor function: Normal
FUNCTIONAL ASSESSMENT
Ability •Ability to perform self-care and do household chores
•Self-maintenance and physical abilities and active in doing
household chores
Disability •Can’t carry heavy things and get tired easily.

Activities of Daily Living Index

Katz Index of Independence in Activities of Daily Living

Activities Independence Dependence

Points (1 or 0) (1 Point) NO supervision, (0 Points)
direction or personal WITH supervision, direction,
assistance. personal assistance or total
care.

BATHING (1 POINT) Bathes self (0 POINTS) Need help with

Points: 1 completely or bathing more than one part of
needs help in bathing only a the
single part body, getting in or out of the
of the body such as the back, tub or
genital shower. Requires total
area or disabled extremity. bathing

DRESSING (1 POINT) Get clothes from (0 POINTS) Needs help with

Points: 1 closets dressing self or needs to be
and drawers and puts on completely dressed.
clothes and
outer garments complete with
fasteners.
May have help tying shoes.

TOILETING (1 POINT) Goes to toilet, (0 POINTS) Needs help

Points: 1 gets on and transferring to the toilet,
off, arranges clothes, cleans cleaning
genital area self or uses bedpan or
without help. commode.

Geriatric Assessment Workshop D.I. Halbi

 TRANSFERRING (1 POINT) Moves in and out
Points: 1 of bed or (0 POINTS) Needs help in
chair unassisted. Mechanical moving
transfer from bed to chair or requires
aids are acceptable a
complete transfer.

CONTINENCE (1 POINT) Exercises (0 POINTS) Is partially or

Points: 1 complete self totally
control over urination and incontinent of bowel or
defecation. bladder

FEEDING (1 POINT) Gets food from (0 POINTS) Needs partial or

Points: 1 plate into total
mouth without help. help with feeding or requires
Preparation of food parenteral feeding.
may be done by another
person.

TOTAL POINTS: 6 ( patient is independent) SCORING: 6 = High (patient

independent) 0 = Low (patient very dependent

Source:
try this: Best Practices in Nursing Care to Older Adults, The Hartford Institute for Geriatric
Nursing, New York University
INSTRUMENTAL ACTIVITIES OF DAILY LIVING: In circle the Number of each scale and
add the Total to get the IADL ability of the Patient

Geriatric Assessment Workshop D.I. Halbi

 LAWTON - BRODY
INSTRUMENTAL ACTIVITIES OF DAILY LIVING SCALE (I.A.D.L)
Scoring: For each category, circle the item description that most closely resembles the
client’s highestlevel (either 0 or 1)
A. Ability to use the Telephone
1. Operates telephone on own initiative-looks up and dials numbers, etc. 1
2. Dials a few well-known numbers 1
3. Answers telephone but does not dial 1
4. Does not use telephone at all 0
Shopping
B.
1. Takes care of all shopping needs 1
Independently 1
2. Shops independently for small purchases 0
3. Needs to be accompanied on any shopping trip
4. Completely unable to shop
C. Food Preparation
1. Plans, prepares and serves adequate meals independently 1
2. Prepares adequate meals if supplied with ingredients 0
3. Heats, serves and prepares meals, or prepares meals, or prepares meals 0
but does not maintain adequate diet
4. Needs to have meals prepared and served 0
D. Housekeeping
1. Maintains house alone or with occasional assistance (e.g. "heavy work 1
domestic help")
2. Performs light daily tasks such as dish washing, bed making 1
3. Performs light daily tasks but cannot maintain acceptable level of 1
cleanliness 1
4. Needs help with all home maintenance tasks 0
5. Does not participate in any housekeeping tasks
E. Laundry
1. Does personal laundry completely 1
2. Launders small items-rinses stockings, etc. 0
3. All laundry must be done by others 0
F. Mode of Transportation
1. Travels independently on public transportation or drives own car 1
2. Arranges own travel via taxi, but does not otherwise use public 1
transportation 1
3. Travels on public transportation when accompanied by another 0
4. Travel limited to taxi or automobile with assistance of another 0
5. Does not travel at all
G. Responsibility to Own Medications
1. Is responsible for taking medication in correct dosages at correct time 1
2. Takes responsibility if medication is prepared in advance in separate 0
dosage 0
3. Is not capable of dispensing own medication
H. Ability to handle Finances
1. Manages financial matters independently (budgets, writes checks, pays 1
rent, bills, goes to bank), collects and keeps track of income
2. Manages day-to-day purchases, but needs help with banking, major 1
purchases, 0
Geriatric Assessment Workshop D.I. Halbi
3. Incapable of handling money
TOTAL SCORE 5
A summary score ranges from 0 (low function, dependent) to 8 (high function,
independent) for women and 0 through 5 for men to avoid potential gender bias.
Geriatric Depression Scale
15-Item Geriatric Depression Scale (GDS-15)
Are you basically satisfied with your life? YES
Have you dropped many of your activities and interests? NO
Do you feel that your life is empty? NO
Do you often get bored? YES
Are you in good spirits most of the time? YES
Are you afraid that something bad is going to happen to you? YES
Do you feel happy most of the time? YES
Do you often feel helpless? NO
Do you prefer to stay at home, rather than go out and do new YES
things?
Do you feel you have more problems with memory than most? YES
Do you feel pretty worthless the way you are now? NO
Do you think it is wonderful to be alive? YES
Do you feel full of energy? YES
Do you feel that your situation is hopeless? NO
Do you think that most people are better off than you are? NO
15-Item GDS score Score 9- Mild
(Score 1 for answers in block capitals: 0-4 yes normal, 5-9 Mild Depression
depression, 10-15 More severe depression)
Dr Yesavage has confirmed that the original scale (from which the calculator has been derived) is in the public domain due to it being partly the
result of US Federal support.
The 15-item (GDS-15) and 4-item (GDS-4) versions of the GDS are good methods of screening for major depression (as is the 10-item version).
The shorter of these (GDS-4) is of limited clinical value in monitoring the severity of the depressive episode (may be better used to exclude
depression).[4] The systematic use of short GDS versions in Primary Care may increase detection rates of depression among the elderly. [5]

NURSING DIAGNOSIS

Geriatric Assessment Workshop D.I. Halbi

 Activity intolerance related to imbalance between oxygen supply and demand.

HEALTH TEACHING for patient who has Anemia:

• Provide nutritional education

o Increase green leafy vegetables
o Incorporate foods high in vitamin C
o Intake of red meat, lamb, poultry and venison as well as fish and shellfish
o Intake of seafood and shellfish
o Limit or avoid intake of foods high in calcium

• Leafy greens such as spinach, kale and chard are high in iron and folate
• Vitamin C assists in the absorption of iron. Good choices include oranges, red peppers
and strawberries
• All meats and most fish and shellfish contain heme iron
• Calcium-rich foods such as raw milk, yogurt, cheese and broccoli are high in calcium,
which binds with iron and prevents absorption

Treatments vary widely based on anemia type and severity. Caring for seniors struggling with
may include therapies ranging from relatively simple supplementation and dietary awareness, to
more complex approaches. Here are some of the common anemia treatments:
• Iron supplementation
• Ferrous sulfate
• Ferrous gluconate
• Ferrous fumarate
• Polysaccharide iron
• Iron supplementation note: If patient cannot tolerate ferrous sulfate due to adverse GI
effects, ferrous gluconate is often better tolerated although not absorbed as well.
• B12 supplementation
• Folate supplementation
• Dietary considerations
• Seafood
• Red meats
• Beans and whole grains
• Vegetables
• Blood transfusion
• Treatment of underlying cause or condition
Help residents increase supplement effectiveness with the following education:
1. Antacids or calcium should not be ingested within four hours of iron supplements.
2. Iron supplements are best taken on an empty stomach, if tolerated.
3. Taking Vitamin C with iron may increase absorption rate.

Geriatric Assessment Workshop D.I. Halbi