Module 12:
Assessment of Living
Conditions of Older
I. Home Assessment
1. Around the House
• Keep furniture to minimum
• Avoid having mats on the floor or make them securely fastened
• Check for worn carpets and loose flooring as these can be hazardous
• Be careful of loose cords hanging on the telephones or other house
implements, for the older person can easily trip these.
• Keep areas well lit at night: nigh light (Blue or green light bulb)
• If the older person has difficulty getting in and out of chairsm use
chairs with arm rest for leverage
• Check if older person has access to clocks, calendars and newspapers.
2. Bedroom
• Check height of bed
• Instruct the older person to take time to gain balance when getting io
from chair or bed
• Instruct the older person to wear shoes or slippers that have slip-
resistant tread patterns and have low heals with a broad surface.
3. Bathroom
• Check slippery surface on the floor and avoid mats in the bathroom
unless firmly fixed
• Rails may be fitted in the shower or bath to help the older person get
in and out or to steady himself or herself.
• Have a nonslip bath mat or shower.
• If getting on and off the toilet is difficult, consider installing handrails
and perhaps a raised toilet seat.
• Hand-held showers may be convenient for some
• Ask if the shower access can be altered so that the older person does
not need to step over anything to get into it
• Avoid using electrical appliances in the bathroom
4. Kitchen
• Put Items for everyday use where they can be reached easily.
• Try to have power outlets placed where they are easy to reach.
• Observe safety precaution with electrical appliances
• Make sure the floor surface is non-slip and always clean up water,
food spills, etc.
• Ask for specific gadgets that may help the older person in turning off
stove knobs, pouring for kettles
• Encourage the older person to ask for help with tasks that might be
too risky, such as transferring heavy pots an pans, pouring boiling
water in to a thermos etc.
4. Kitchen
• Put Items for everyday use where they can be reached easily.
• Try to have power outlets placed where they are easy to reach.
• Observe safety precaution with electrical appliances
• Make sure the floor surface is non-slip and always clean up water,
food spills, etc.
• Ask for specific gadgets that may help the older person in turning off
stove knobs, pouring for kettles
• Encourage the older person to ask for help with tasks that might be
too risky, such as transferring heavy pots an pans, pouring boiling
water in to a thermos etc.
Form
Nutrition
• Calcium—important for bone density and strength, calcium is found in dark leafy greens and dairy
products, as well as calcium-specific supplements. Calcium deficiency can lead to decreased bone
density, lowered mobility, and falls.
• Vitamin D— this vitamin works in conjunction with Calcium to promote bone health and strength.
Vitamin D is naturally absorbed by the body through sunlight, but can also be found in certain
types of fish and fortified foods like orange juice or milk.
• Magnesium—this mineral plays a part in many body processes like glucose and blood pressure
regulation. Magnesium is found in many plant and animal food sources, especially dark leafy
greens, nuts, seeds, and whole grains.
• Vitamin C—this vitamin plays a role in the absorption of proteins, as well as the creation of
connective tissue, which is vital for wound healing. Vitamin C also contains antioxidants that may
help fight diseases like cancer. Brightly colored fruits and vegetables are the best sources of
Vitamin C, like citrus fruits, tomatoes, and bell peppers.
• Vitamin E—the antioxidant qualities of Vitamin E allow it to combat disease-causing free radicals.
This vitamin also supports immune system functioning. Vitamin E can be found in nuts, seeds, and
vegetable oils.
• Vitamin B6— B vitamins perform many functions in the body, primarily supporting protein
absorption and cognitive function. The richest sources of B vitamins are fish, organ meats (like
liver), potatoes, and other starchy vegetables.
Activities
• Ability to perform ADL
• Observe performance in doing domestic chores
• recreation
Medication
• Check for medication
• Assess effect or medicines
• Compliance (meds,dose, time,& route)
• Storage
• Check prescription
Family Support
• Interpersonal relationship with family and society
• Support and decision making
• Ability to manage finances
• KAS to take care of Older adult
• Well placed support system
Access to Services
• Transportation
• Outreach
• Adult day care
• Nutrition program
• Rehabilitation servies(Support groups, senior centers, abuse
protective services,health)
Visual and Hearing Impairment
• Visual and hearing impairment also affect the health status of older
person
• Visual contribute to safety hazards
• Hearing may affect communication
Decreased organ reserves
• as we grow older, our body organs gradually diminish in their
function.
• Effects of illness on the decreases functional reserves
Chronic Illness
• Hypertension
• Arthritis
• Osteoarthritis
• Rheumatoid arthritis
• Heart Diseases
• Diabetes
Living Arrangement
• Living arrangement can affect the status of an older adult
• Living in isolation, absence of welfare services exposes to certain risk,
possible illness and decreased quality of life.
• Lack of Physical, social and economic support
MODULE 10:
PRINCIPLES AND TECHNIQUES IN
ASSESSMENT OF THE HEALTH STATUS OF
OLDER PERSONS
Common Types of Assessments
1. History-Taking
• Entails an interview with the older person on certain aspects of health such
as:
• Activities of daily living (ADL)
• Nutrition
• Specific health concerns
• To important matters to consider during inter view:
• Orientation to time place and person
• Memory state
• Understanding questions
• Asking questions on current health concerns of the order person on specific
dimensions:
• Physical Health
• Functional Status
• Psychological function
• Social function
• Functional Health Patterns
2. Physical Assessment
• The process of examining the body for signs and symptoms of disease and
other health problems.
• Ex. Inspection, palpation, percussion and aucultation
Factors Affecting Validity of the Assessment
I. Presence of disease
II. Presentation of illness
III. Expertise of persons doing the assessment
IV. Place and time
I. Presence of disease
• History taking is not conducted properly and some errors are
committed due t some visual or hearing impairment affecting
communication
• Older clients not oriented with the interview
• Older person may refuse to answer questions because of depression,
confusion and dementia.
Cognitive Impairments
Depression
• also known as major depressive disorder, is a mood disorder that
makes you feel constant sadness or lack of interest in life.
• intense sadness -- including feeling helpless, hopeless, and worthless
-- lasts for many days to weeks and keeps you from living your life, it
may be something more than sadness.
Confusion
• Brain impairment in which memory thinking and perception are
simultaneously impaired
• Has acute and reversable causes
• Symptoms:
• Reduced ability to maintain or shift attention
• Disorganized thinking
• And two or more of the following: reduced level of consciousness, perceptual
disturbances, sleep-wake cycle disturbance, increased or decreased
psychomotor activity, disorientation to time/place/person and memory
Dementia
• Chronic deterioration of memory and loss of other cognitive function.
• It is caused by the structural loss or death of nerve cells in the brain.
• Symptoms:
• Impaired abstract thinking
• Impaired judgement
• Personality change
• Aphasia
• Apraxia
• Constructing Difficulty
II. Visual and Hearing
• Difficulty in communication with older persons
• Visual problems may be difficult for older persons to answer
questionnaire or demonstrate some activities
• Visual problems affect ADLs
• Hearing problems can limit participation in the assessment process
• Sensory limitations must be checked early on during assessment.
Affective disorders: Depression
• Difficulty in communication
• It is important that the older person be pulled out of depression
before conducting assessment
• Focus purpose of the assessment
• Motivate person on certain task
• Although depression may affect the assessment of the older person,
inputs should still be considered, but needs to be validated
Presentation of Illness
• Many older persons do not report signs and symptoms of disease.
Attributed to normal signs of aging. Afraid to be subjected to clinical test
• Under Reporting of diseases
• Ask specific questions on the health problems
• Address fears or other emotional concerns
• Atypical Presentation of Illness
• Certain signs and symptoms of diseases that are reported by older persons must be
checked with corresponding laboratory test.
• Multiple inter-acting diseases
• Cumulative bad health habits in the past make older person cadidates for specific
chronic illness
Person doing the assessment
• Knowledgable
• Validate certain findings and plan appropriate care
• Respect towards person
• Establish rapport
• Trust confidence
• Make client feel comfortable
• Stat purpose clearly
Techniques in conducting assessment
• Setting: Privacy and Comfort
• Assessment should be done ina room where privacy, safety and cmfort be
guaranteed
• Client must be. made comfortable ad safe
• Furniture must be arrange for safety
• Examination equipment and supplies designed for older adults
• Well lighted not too bright
• Quiet
• Avoid visual distractions
• Establishing Rapport and trust
• Introduce self
• Explain purpose
• Procedure
• Address the older person formally
• Older person’s SO should be part of the plan
• Validate question to family member
• Communication tecniques
Communicating with older persons with
sensory impairment
• Provided nonverbal cues (ex. Head movements, mouth movements
and eye movements)
• Guidelines for communicating with a hearing impaired person
1. Get person’s attention before speaking
2. Face him or her directly to provide cues
3. Speak slowly and clearly in a normal tone
4. Turn off background noise
5. Rephrase message
6. Signify changes in topic by pausing long enough before proceeding
7. Avoid movements while talking
8. End session by properly saying it is ended
END
Module 13:
Promoting Effective Breathing
and Circulation
Interventions to Maintain Effective Breathing
and Circulation
• Ensuring airway patency
• Blowing of nose and cleaning with soft tissue can help
• Use cotton tip to remove, harder particles (Caution)
• Promote breathing exercises
Promoting Circulation
• Ensuring BP is maintained at acceptable range
• Changing position
• Preventing pooling of blood in the extremities
• Eliminating source of pressure on the body
• Preventing ulcer formation (by drying moisture on the skin due to
sweat)
• Encourage regular physical activity
• Monitoring drugs for side effects of hypotension
• Educating to reduce health risk
Promote Mobility
• Movement of each body part several times a day frequent position
changes are essential to good health
• Turn to sides & massage back lightly every 2 hours
End