Design evaluation plans for patients with immobility, sensory deprivation, and/or cognitive dysfunction. Identify immunization requirements related to health promotion and disease prevention for older adults.

Assessment of Older Adults

Consider a 92-year-old patient who has been diagnosed with several disorders, including obstructive sleep apnea, hypertension, mild chronic anemia, restless leg syndrome, and osteoporosis. Despite these disorders, he can independently perform all basic activities of daily living, walk a quarter mile without difficulty, and pass functional and cognitive assessments. However, he did report that he fell a few times and had lost his way while driving to a familiar location . As an advanced practice nurse caring for geriatric patients, you will likely encounter patients like this. While he can pass the basic assessments, the report of falls and confusion might indicate underlying issues of immobility, sensory deprivation, and/or cognitive dysfunction that require further attention. To identify these potential underlying issues and distinguish between normal and abnormal changes due to aging, healthcare providers use a variety of assessments. These assessments are a key tool in the care of geriatric patients.

You examine assessment tools and evaluation plans used to assess geriatric patients presenting with potential issues of immobility, sensory deprivation, and cognitive dysfunction.

You will analyze assessment tools used to assess older adults; design evaluation plans for patients with immobility, sensory deprivation, and/or cognitive dysfunction; and identify immunization requirements related to health promotion and disease prevention for older adults.

Case Study :

Mr. Abrams, a 69-year-old man, was referred to your office for a hearing evaluation. He continues to work in a printing company, although he works only part time. He has worked at the printing company for the past 35 years. He complains that he cannot hear much of the dialogue on the television. He is accompanied by his wife, who states that her husband cannot hear her at home. He has no history of dizziness, tinnitus, or vertigo. He has had cerumen impactions removed from both ears in the past. Overall, his medical history is quite benign. His only medications are aspirin 81 mg. daily, a multivitamin daily, and occasional ibuprofen for back pain.

Review the case study and based on the provided information, think about a possible patient evaluation plan. As part of your evaluation planning, consider where the evaluation would take place, whether any other professionals or family members should be present, appropriate assessment tools and guidelines, and any other relevant information you may wish to address.
Consider whether the assessment tool you identified was validated for use with this specific patient population and if this poses issues. Think about additional factors that might present issues when performing assessments such as language, education, prosthetics, missing limbs, etc.
Consider immunization requirements that may be needed for this patient.
Keep in mind that as nurse practitioners, whether you are primary care or acute care, patient and family education is always important. This includes education about medications, tests, treatment plans, immunizations, diagnosis, and health promotion.

Analyze assessment tools used to assess older adults.
Design evaluation plans for patients with immobility, sensory deprivation, and/or cognitive dysfunction.
Identify immunization requirements related to health promotion and disease prevention for older adults.

Reference:

Carr, D. B., & Ott, B. R. (2010). The older adult driver with cognitive impairment: “It’s a very frustrating life.” Journal of the American Medical Association Links to an external site., 303(16), 1632–1641. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915446/

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