GERIATRIC HEALTH ASSESSMENT

Date: September 4, 2022

Interviewer: Ann Jermaine M. Magalang

I. Demographic Details

Name: Norilen M. Magalang

Phone: 09308290510
Address: Purok Yakal, Barangay Tanza, Boac, Marinduque

Birthdate: December 26, 1964

Birthplace: Barangay Duyay, Boac, Marinduque
Age: 57 years old Gender: Female Marital Status: Married
Occupation: Housewife
Race/Ethnic: Tagalog
Origin: Barangay Duyay, Boac, Marinduque

II. Source and Reliability:

The patient is the primary source of information as she manifests credibility
in her answers.

III. Reason for seeking care/Chief Complaints:

"Ako ay palaging nanlalabo ang mga mata at madalas na sumasakit ang likod."

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IV. Present Health or History of Present Illness:
Specify:
✓Visual Impairment

✓ Locomotive disorders, joints, muscles

Neurological disorders
Cardiovascular disease
Respiratory disorders
Weight Changes
Gastro-intestinal/ Abdominal disorder
Psychiatric problem
Hearing loss
Genitourinary disorder

V. Past Health History:

General Health:
The patient does not have any serious health problems. However, she
experiences back pain and visual impairment.

Child Illnesses:
_None

Accidents or Injuries:

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_None

Serious or Chronic Illnesses:

_None

Hospitalizations:
_"Noong nanganak ako sa dalawa kong anak."

Operations:
_"Dalawang beses akong na-cd noong nanganak ako."

VI. Family History

Specify:
Heart Disease: Allergies: ✓
High Blood Pressure: Asthma:
Stroke: Obesity:
Diabetes: Alcoholism:
Blood Disorder: Mental Illness:
Breast Cancer: Seizure Disorder:
Other Cancer: Kidney Disease:
Arthritis: Tuberculosis:

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VII. Functional Assessment

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◯

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 VIII. Focused Geriatric Physical Examination

Areas of Assessment Physical Signs and Symptoms

A. Vital Sign
Blood Pressure 100/90 mmHg
Heart Rate 95 beats per minutes
Respiratory Rate 17 breaths per minute
Temperature 35.3°C
B. General Weight gain

Head No problem
Eyes Impaired visual acuity
Ears No problem
Mouth and Throat No problem
Neck No problem
Cardiac No problem
Pulmonary No problem
Breasts No problem
Abdomen No problem
Gastrointestinal No problem
Genital No problem
Rectal No problem
Extremities No problem
Musculo-Skeletal Back pain
Skin No problem
Neurologic No problem
Others:

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Guided Focused Geriatric Physical Examination

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IX. Nutritional Health Checklist

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 X. Screening Version of the Hearing Handicap Inventory for the Elderly

✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
0

XI. Mini-Cognitive Assessment Instrument (Mini-Cog)

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XII. Medication List
_None

XIII. Problems Identified

_Back pain and impaired visual acuity.

IX. Conclusion
All the information that was collected is all stated by the client herself.
Therefore, I conclude that the patient is in healthy condition and in good shape.
But as she ages, she experiences several signs of aging. The patient must have
an immediate action or treatment for that.

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