Transitional care:
transitional care encopasses both the sending and the receiving
aspects of the transfer
Health assessments in older adults
Chronic conditions in addition to acute conditions
Manifestations of illness less predictable (ex UTI)
Multiple possible causes of symptoms
Treatments for symptoms control instead of identifying an
underlying cause
Cognitive impairment
Often underlying illnesses not identified until advanced stage
Myths and misunderstandings
Types of assessment:
Physical assessment
Functional assessment
Mental status assessment
,Comprehensive geriatic assessment
Environmental and safety assessment
Other assessment
Nursing assessment tools
Purpose: to identify specific areas that need to be addressed in
the nursing care plan
Should be:
Evidence-based
Easy-to-use
Interviewing older adults
Preparing the physical setting
Noise, lighting, comfortable furniture, privacy bathroom
Establishing rapport
Use formal names
Explain the purpose
Speak directly to the older person
Maintain the modesty standards set by each culture
Structuring the interview
Brief interactions less than 30 minutes each
Avoid medical jargon
,A summary of restatement
Prepare the older person for the end of the interaction
Physical assessment
Obtain the health history before starting physical assessment
Head to toe
Measuring vital signs in older adult
Measuring vital signs in older adult
Temperature: 36 in older adults
Pulse: 50-90 bpm irregular pulse, sometimes weak thready
pulses because of dehydration, full and bounding pulses can
happen because of excess fluid
Respiration: 12-20, slowking them is significant for older adults,
infection, this can change even before the temperature so it can
tell you a lot of things
Blood pressure: can decrease and also go up because of pain,
smoking etc
-Orthostatic hypotension: laying to setting then wait 5 min and
check then from sitting to standing wait 5 min and check if
change more than 20 then they are at risk
Functional assessment
, Refers to the measurement of a person's ability to fulfil
responsibilities and perform self care tasks
It should measure primarily:
-ADLS
Instrumental activities of daily living
-Level of assistance needed (ie, independent, semi-independent,
dependent)
-Sensory function (ie, vision/hearing, etc)
-Cognitive function (baseline mental status)
The Katz Index of ADLs
Quick 5 minute assessment of functionality
Good for daily use in hospital or long-term care settings
Missing assessment of cognition and mobility
Assesses independence/dependence in the following areas
-Bathing
-Dressing
-Toileting
-Transferring
-Continence
-Feeding
FANCAPES
F - Fluids
A - Aeration