Gerontological Nursing – 2 credit undergraduate course Page 5 of 20
Week 2: Nursing assessment of the older adult
Learning objectives: Describe how the nature of illness presentation, changes in homeostatic mechanisms and the lack of normative standards for older adults affect the assessment process Explain rationale for conducting assessments of functional status in older adults and considerations for baseline comparisons Describe elements of general assessment and useful assessment tools Discuss rationale for integrating findings from physical, psychosocial, functional, and environmental assessments
Overview: steps to assessment
Use elder‟s previous status as baseline for setting unique, individualized standard
Differentiate normal age-related changes from disease states
Prevention, early detection, proper intervention, proper evaluation of treatment effects, identification of adverse reactions/side effects
Altered/atypical presentation and response to specific diseases (i.e., modified, unrelated, absent)
Cumulative and integrated effects of multiple losses: psychosocial/physiologic conditions, functional changes
Short term/long term functional implications (ADLs, IADLs)?
Failure to thrive – what is this? Multi-layered, multi-dimensional
Socio-cultural, environmental, economic, physiologic, psychologic
Standards for “normal aging”
Absence of norms for many pathological conditions
Landmarks for development after 65? Are they the same at ages 75, 85, 90?
Baseline for functional status
Assessment tools (general)
Try this: Best Practices in Nursing Care of Older Adults
i. ii. iii. iv. v. vi .
Fulmer SPICES: An Overall Assessment Tool of Older Adults Katz Index of Activities of Daily Living Beers‟ Criteria for Potentially Inappropriate Medication Use in the Elderly Predicting Pressure Ulcer Risk Fall Risk Assessment Nutritional Assessment?
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