ASSESSMENT OF

OLDER ADULTS
THE HEALTH HISTORY
The first phase of a comprehensive,
nursing –focused health assessment
Provide a subjective account of the
older adult’s current and past health
status
The interview forms the basis of
therapeutic- patients relationship
May have the therapeutic effect of
serving as a life review
Basic Components Of A Nursing Health
History
 Patient Profile/Biographic Data
Family Profile
Occupational Profile – current
work/retirement status
Living environment Profile – type of
dwelling
Recreation/Leisure Profile – hobbies,
organization membership
Resources/Support System –
community services used, name of
physicians
Description of a typical day – type and
amount of time spent in each activity
Past health history
Present health history – symptom
analysis
Review of System
REVIEW OF SYSTEM SAMPLE
GUIDE
Check Yes or No for each symptoms
GENERAL
Fatigue
Weight changes in 1 year
Sleeping difficulty
Ability to carry out activities of daily
living___________________________________________
REVIEW OF SYSTEM SAMPLE
GUIDE
REVIEW OF SYSTEM SAMPLE GUIDE
REVIEW OF SYSTEM SAMPLE GUIDE
EYES

Vision changes
Glasses
Pain
Excessive tearing
Pruritus
Blurring
Floaters

Date of most recent vision examination _______________________

REVIEW OF SYSTEM SAMPLE
GUIDE
REVIEW OF SYSTEM SAMPLE
GUIDE
NOSE AND SINUSES
Rhinorrhea
Discharges
Epistaxis
History of infection
REVIEW OF SYSTEM SAMPLE
GUIDE
REVIEW OF SYSTEM SAMPLE
GUIDE
REVIEW OF SYSTEM SAMPLE
GUIDE
GASTOINTESTINAL
Dysphagia
Heartburn
Nausea/vomiting
Hematemesis
Appetite changes
Changes in bowel habits
Diarrhea
Constipation
Melena
hemorrhoids
REVIEW OF SYSTEM SAMPLE
GUIDE
REVIEW OF SYSTEM SAMPLE GUIDE
REVIEW OF SYSTEM SAMPLE GUIDE
 GENERAL GUIDELINE IN
PHYSICAL EXAMINATION
•Be alert to the older patient’s energy level. Generally, it should take
approximately 30 to 45 minutes to conduct the assessment
•Respect the patient’s modesty
•Keep the patient comfortably draped. Exposed only the part to be
examined
•Sequence the assessment to keep position changes to a minimum
•Explain each step in simple terms
•For reassurance, share findings when possible. Encourage to ask
questions.
 FUNCTIONAL STATUS
ASSESSMENT
 Functional status is considered a significant component of
older adult’s quality life
 Functional status assessment is a measurement of the
older adult’s ability to perform basic self-care tasks, or
ADLs
and task that require more complex activities for
independent living (referred as IADLs)
 As well as the patient’s cognitive, affective and social
levels of function
The Katz Index of ADLs
 Is a tool widely used to determine the results of treatment
and the prognosis in older and chronically ill people
 Ranks the adequacy of performance in six function
 Bathing
 Dressing
 Toileting
 Transferring
 Continence,
 Feeding
 The tool takes only 5 minutes to administer and may used
in most settings
BARTHEL INDEX
Used for measuring functional status
Rate self-care abilities in the areas of:
Feeding
Moving
Toileting
Bathing
Walking
Propelling wheelchair
Using stair
Dressing
Controlling bowel and bladder
 Each item is rated on basis of ability
performance the task independently or with
help; a maximum of 100 score indicates
independence on all items
 Most appropriate for use in rehabilitation
Watch the video on BARTHEL INDEX

https://www.youtube.com/watch?v=WhQB9Dd-sk8
Instrumental Activity of Daily Living
Scale (IDLs)
Represent a range of activities more complex than self-care task
One that measure complex activities such as:
◦ Using telephone
◦ Shopping
◦ Preparing food It may identify people living in the
◦ Housekeeping community who need help, which
◦ Doing laundry enable the nurse to matched services
◦ Using transportation and other source of support for patient
◦ Taking medication
◦ Handling finances
COGNITIVE
ASSESSME
NT
Ø To determine the
patient’s level of
cognitive function
Ø All those process
associated with
mentation or
intellectual
function
COGNITIVE OR AFFECTIVE
ASSESSMENT
The Short Portable Mental Status
Questionnaire
 Used to detect the presence and degree
of intellectual impairment
 Consist of 10 items to assess
 Orientation
 Memory in relation to self-care
ability
 Remote memory
 mathematics ability
 COGNITIVE OR AFFECTIVE
ASSESSMENT
The Mini-Mental State Examination (MMSE)
 Test the cognition aspect of mental functions:
 Orientation
 Registration
 Attention
 Calculation
 Recall
 Language
 Highest score is 30; score of 21 or less generally indicates cognitive impairment
 COGNITIVE OR AFFECTIVE
ASSESSMENT
The Mini-Cog
 An instrument that combines a
WATCH THE VIDEO ON MINI-COG
simple test of memory with a clock https://youtu.be/De7aluks7y8
drawing test
 Created by researchers at the
university of Washington led by Soo
Borson
AFFECTIVE STATUS MEASUREMENT TOOLS
The Becker Depression Inventory
Geriatric Depression Scale

WATCH VIDEO ON BDI

https://youtu.be/6N7dWT-vFsk
SOCIAL ASSESSMENT CARE
Older adults resources and services (OARS) multidimensional Functional
Assessment

 developed in 1978 at Duke University

 to provide an assessment of individual functioning in elderly individuals
 has been used for the clinical assessment, population surveys, program evaluation,
personnel training, and service planning

 Collect information about the individual’s functional ability in five domains:

 Social resources (quantity and quality of relationships with friends and family)
 Economic resources (adequacy of income and other resources)
 Mental health (extent of mental well-being and presence of organicity),
 Physical health (presence of physical disorders)
 Participation in physical activities of daily living