functional assessment of the older adult Flashcards
by 2040 what will the older adult population be
by 2040, older adults will compose over 20% of the population
hospital stays and economic costs of older adults
After the age of 65, account for more hospital stays
Economic costs of aging associated with personal care continue to increase
what age qualifies as aging or older adult
65 years of age or older
comprehensive geriatric assessment is multidimension and includes:
Physical examination
Mental status
Functional status
Social and economic status
Pain
Examination of physical environment for safety concerns
development of disease in the older adult may?
Development of disease may precipitate transition from home to a variety of clinical settings requiring ongoing assessment
functional assessment
Basis for care planning
Assessment from observation and individual’s self-report
Includes
* Physical examination
* Self-care
Activities of Daily Living
Instrumental Activities of Daily Living
* Physical Mobility
instruments for assessments - Katz index for independence in ADLs
- Uses dichotomous scoring for each category
- Activities assessed as independent or dependent
- Advantage versus limitations
instruments for assessments - Lawton Instrumental Activities of Daily living
- To determine most suitable living situation for older adult
- Pre-requisite for independent living
- Self-report instrument
the timed up and go (TUG) test in measuring physical performance
Timed Up & Go (TUG) Test quantify functional activity
Appropriate for use in many settings
How it’s performed:
Patient rises from a chair, walks 10 feet, turns, walks back to the chair, and sits
down while the practitioner times them.
the parts to assessments of cognition
Complete altered cognition not
a normal part of aging
Use of cognitive assessments comparing baseline to present status is a key part in detecting any acute changes
Mini mental status exam (MMSE)
Montreal Cognitive Assessment (MoCA)—
more sensitive
depression and function in older adults
Majority of older adults do not experience
major depression
Depression risk increases with presence of comorbidity
Vital to screen and identify older adults
who have depressive symptoms
social domain in older adults
Focuses on relationships within family, social
groups, and community
Sources of formal and informal assistance available from those relationships
Quality of life linked to success of social function
caregiver assessments for older adults
Most older adults with functional impairment live with help of informal support (family)
Caregiving is linked to both satisfaction and
stress
Older person’s need for institutionalization often better predicted from assessment of caregiver than from severity of patient’s illness
Assess caregiver burden and for burnout
physical environment assessments
Observations to determine safety and modify potential hazards, safety and access
to services
environmental assessments - falls, drivers, sleep
Falls
20% result in serious injury
Older adult drivers
Higher crash rates
Sleep
Changes in sleep pattern not normal part of aging
assessing pain
Assessing those in pain
Alleviating pain should be a priority
Premedication may be required
Positioning for comfort
Using age-appropriate pain scale—“gold standard” —patient self report
what is the most important part for assessing pain, especially in older adults
alleviating pain should be a priority
assessing for altered cognition
Difficulty in obtaining accurate information from patient
Involve the caregiver in the assessment dialogue
what are instruments for daily living (exam)
shopping, cooking, driving, laundry, managing finances, etc.
