Consequences of chronic diseases

The comprehensive assessment of an older adult requires knowledge of not only normal aging changes but also the consequences of chronic diseases, genetic makeup, and lifestyle. A comprehensive geriatric assessment is multidimensional and incorporates the physical examination as well as assessments of mental status, functional status, social and economic status, pain, and examination of the physical environment for safety concerns (Jarvis, 2015). The nurse would assess if the patient was able to perform activities of daily living as well as a complete head to toe assessment. During the assessment the nurse would keep in mind the normal and expected changes that take place as people get older such as hearing and vision loss, change in skin elasticity, hair color changes, loss of subcutaneous fat and decreased height due to thinning of the bones. If the nurse notices hearing loss it would be important to speak clearly and slowly facing the patient during discussion and to not mistake difficulty hearing or loss of vision to mental status change. Skin and nail assessment can lead to knowledge about hydration, cardiac, and nutrition status.

When assessing the geriatric patient in the hospital it is wise to consider if the patient is mobile enough to get by at home. Can the patient go up and down stairs? Does the patient drive? Can the patient see the phone numbers on the phone to call for help? Does the patient have a support system? These are all questions that should be in the nurse’s mind during a comprehensive assessment.

Special consideration to emotional state should take place with the geriatric assessment. It is important to treat the patient with respect and dignity in this stage of life. Do not refer to patients as Honey, Grandma, Grandpa or Sweetheart, but rather Sir, Ma’am, Mr. or Mrs. Many families live across state borders and are not readily available to the geriatric patient who may need extra support. The nurse should be knowledgeable about resources in the surrounding community such as home care, transportation services, social groups, meals on wheels and other low cost organizations that may help to improve the quality of life of a geriatric patient.

Reference

Jarvis, C. (2015). Physical Examination and Health Assessment, 6th Edition. St. Louis, Missouri: Elsevier Saunders\

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