Assesment of Health and

Functioning
Chapter 7
Created by :
Gusti Lanang Ngurah Wiratawan 175139066
Verra Idriyana 175139064
Arum Murti Palupi 175139059
Assessing Health of Older Adults
Assessment of older adults is a multidimensional
process addressing the complex interactions among
older adults, their health, and all contextual factors (e.
g., culture, environments, medical conditions,adverse
medication effects).
Factors that contribute to the complexity of assessing
older adults include multiple interacting conditions,
unique manifestations of illness, treatments that mask
theunderlying problem, inaccurate or inadequate
sources ofinformation, and myths and
misunderstandings about aging.
Nurses need to be aware of age-related variations
inlaboratory values for older adults (Table 7-1).
ASSESSING HEALTH OF OLDER ADULTS
Older adults commonly have various kinds of diseases
in older adults disease manifestations tend to be
unknown and unpredictable than in younger adults.
Treatment is often directed to symptoms while the
source of the problem is unclear and unresolved
Cognitive disorders can make it difficult for adults to
accurately report or explain physiological problems and
there may be little or no reliable sources of information
In many cases, the older adults detected have chronic illness
Myths and misunderstandings can lead health care older
adults in to the falls treatment
ASSESSING FUNCTION OF OLDER ADULTS
Functional assessment scales measure the
following six activities of daily living (ADLs)
toileting
Feeding
Dressing
Grooming
Bathing
ambulation
Functional Assessment
• A functional assessment is a formal process of measuring
a person’s ability to fulfill responsibilities and perform
self-care tasks (Figure 7-1).
• Functional assessment tools focus on the person’s ability
to perform ADLs and IADLs, as illustrated in Figure 7-2
and Boxes 7-1 and 7-2.
• Assessment of the home environment is important for
identifying factors that affect safety, comfort, functioning,
and quality of life (Box 7-3).
• Assessing the use of adaptive equipment and assistive
devices is important for identifying factors that affect
safety, comfort, and functioning (Table 7-1).
• Some assessment tools address the effect of cognitive
impairment on ability to perform activities of daily living
(Figure 7-3).
• Nurses can suggest the use of innovative and inexpensive
devices to improve functioning and promote independence.
Assessing Older Adults in Relation to Their
Environments
• Everyday competence is a term that describes
the effects of cultural, physical, cognitive,
emotional, social, and contextual factors on a
person’s daily functioning.
• Home assessments are essential for identifying
risks
for safety and interventions to improve
functioning (Box 7-3)
ASSESSING OLDER ADULTS IN RELATION TO THEIR
ENVIRONMENTS
Functional assessment of older adults. This form
allows for recording changes over time. The three
time designations indicated on the form signify
the period prior to admission (PTA), the time of
admission (ADM), and the day of discharge
(DISCH). The unmarked columns may be used at
any time after discharge, or upon readmission.
(Used with permission from Fairview General
Hospital, Cleveland, OH.)
COMPREHENSIVE GERIATRIC
ASSESSMENTS
all nursing homes that receive Medicare or
Medicaid funds have been using the MDS
Minimum Data Set (MDS) for Resident
Assessment and Care Screening, includes several
hundred items that document 18 areas of
functioning, suchas medical, mental, and social
characteristics of nursing home residents.
ASSESSING AND ADDRESSING
DRIVING SAFETY
Assessing and Addressing Driving Safety
• Nurses have an important role in identifying risk
factors that compromise safe driving in older adults.
• Common risk factors include conditions that affect
vision,cognition, motor responses, and reaction time.
• Nurses address risk factors by facilitating referrals
for further evaluation or for programs related to
driving safety, education, and rehabilitation.
THANK YOU