Older Adult Health History

Question 1

What are some things to consider when taking a health history from an older adult patient?

Answer 1

• Adjust the office environment (Increase the lighting, temperature of the room)
• Face the patient directly sitting at eye level
• Choose a quiet room free of distractions (many older adults have hearing deficits)
• Allow time for open-ended questions and reminiscing
• Ask direct questions, Gero patients commonly underreport their symptoms
• They have atypical presentations of illness
• Assess for common geriatric syndromes of: Incontinence, Falls, Pressure Ulcers, Delirium, and functional decline

Question 2

What are some ADLS?

Answer 2

• Bathing
• Dressing
• Toileting
• Transferring
• Continence
• Feeding

Question 3

What are some iADLS (instrumental activities of daily living)?

Answer 3

• Using the telephone
• Shopping
• Preparing food
• Housekeeping
• Laundry
• Transportation
• Taking medicine
• Managing money

Question 4

How should you approach the medication history for an older adult?

Answer 4

• Be thorough: ask the name, dose, frequency, and the patient’s view of the reason for taking the drug
• Ask the patient to bring all medication bottles and OTC drugs
• Explore possible polypharmacy
• Ask specifically about vitamins & nutritional supplements, and mood-altering drugs
• Keep the number of drugs prescribed to a minimum

Question 5

How should you approach acute and persistent pain in an older adult?

Answer 5

• Pain usually arises from musculoskeletal complaints such as back and joint pain
• Older patients are less likely to report pain, leading to suffering, depression, social isolation, physical disability, and loss of function
• Use the term “persistent pain” instead of chronic pain with older adults
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Question 6

How should you approach smoking & alcohol in an older adult?

Answer 6

• Encourage patient’s to stop smoking to reduce their risk of heart disease, pulmonary disease, malignancy, loss of daily function
• Older adults should have no more than 3 drinks in a day or 7 drinks in a week.
• Drinking an exacerbate cirrhosis, GI bleeding, reflux, gout, hypertension, diabetes, insomnia, gait disorders and depression
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