Older Adult assessment

Question 1

Our aging population

Answer 1

• over 65; double by 2050

- over 85; triple by 2050

Question 2

Statistics

Answer 2

-Older adults account for:
14% of the US population
45% of hospital capacity 
37% of surgical procedures
26% of physician visits
82% of home health visits

Question 3

Where are they living?

Answer 3

• Less than 5% of the 65+ population live in institutional settings such as nursing homes
• The percentage increases with age, ranging (in 2011) from 1% for persons 65-74 to 3% for persons 75-84 years and 11% for persons 85+
• In addition, in 2009, approximately 2.7% of the elderly lived in senior housing with at least

Question 4

Physical Assessment of Older adults

Answer 4

• aging doesn’t follow a predictable course or consistent course in everyone
• Normal age related changes vs pathology; may mistake a health problem for normal aging or vice versa
• Multiple chronic conditions complicate assessment
• Polypharmacy
• Atypical presentation during acute illness - e.g. cognition may be affected with infection (UTI, pneumonia) CONFUSION IS NEVER NORMAL

Question 5

General Survey: Expected age related changes

Answer 5

• loss of hair
• thinning of skin / skin discolorations
• posture (kyphosis)
• be alert for signs of abuse or neglect: cleanliness / personal hygienec, nutritional status, mood and affect

Question 6

Level of Consciousness (LOC)

Answer 6

-Alert and Oriented x 4?; determine baseline; assessment tools: pain 0 - 10 scale; PAINAD (observation for those with advanced dementia) - breathing, vocalization, facial expression, body language, consolable MISSING

Question 7

Age related skin changes

Answer 7

• decreased in skin turgor, subcue fat, and connective tissue
• epidural cells become thinner MISSING INFO
• Skin cancers; view slide

Question 8

Skin: Nursing considerations

Answer 8

• Assess skin turgor over sternum or clavicle
• Assess skin for signs of bruising / tears
• Increased risk for pressure ulcers : examine pressure points and bony prominences
• Hydration / lotion for dry skin
• Assess lesions: damage from sun, smoking; normal vs pathology

Question 9

Communication Interventions: Neuro and HEENT

Answer 9

• Demeanor and respect
• cognition: pace, speaking slowly, allow time to answer questions; avoid medical jargon
• impaired vision
• impaired hearing