NURSING AND

MIDWIFERY TRAINING
COLLEGE, BOLE.
COURSE:GERONTOLOG
Y AND HOME
NURSING
GROUP PRESENTATION
GROUP ONE (1)
Assessing older adults

A. Systematic geriatric
Assesment

B. Health history

C. Physical assesment

D. Geriatric assesment
(Functions and cognition)
A. SYSTEMATIC GERIATRIC ASSESSMENT
(SGA) is a comprehensive evaluation of an
older adult's physical, cognitive, and
functional abilities. It aims to identify health
risks, improve function, optimize care, and
enhance quality of life.
COMPONENTS OF SGA
1. Medical History: Review of medical conditions,
medications, and allergies.
- Examples: hypertension, diabetes, arthritis,
medication adherence, and potential side effects.
2. Physical Examination: Evaluation of physical
function, mobility, and sensory impairments.
- Examples: assessing gait, balance, strength,
vision, and hearing.

3. Cognitive Assessment: Evaluation of

cognitive function, including memory,
attention, and decision-making.
- Examples: using standardized tools like the
Mini-Mental State Examination (MMSE) or
Montreal Cognitive Assessment (MoCA).
4. Functional Assessment: Evaluation of
activities of daily living (ADLs) and
instrumental activities of daily living (IADLs).
- Examples: assessing ability to perform
tasks like bathing, dressing, managing
finances, and cooking.

5. Social Assessment: Evaluation of social

support, living situation, and access to
resources.
- Examples: assessing living arrangements,
social connections, and access to
transportation and healthcare.
Tools and Techniques
1. Standardized assessment tools:
Using
validated tools like the Activities of Daily Living
(ADL) scale, Instrumental Activities of Daily Living
(IADL) scale, and Geriatric Depression Scale (GDS).

2. Comprehensive geriatric assessment:

Incorporating input from multidisciplinary
teams, including healthcare providers, social
workers, and therapists.
Benefits
1. Early identification of health risks: SGA helps
identify potential health problems early, allowing
for timely interventions.
2. Personalized care plans: SGA informs the
development of tailored care plans that address
individual needs and goals.
3. Improved health outcomes: SGA can lead to
better health outcomes, reduced hospitalizations,
and improved quality of life.
4. Enhanced patient -centerd care: SGA promotes
patient -centerd care by considering the
individual's needs and preferences
APPLICATIONS OF SGA
1. Primary care: SGA can be used in primary care
settings to identify health issues early.
2. Geriatric clinics: SGA is often used in
geriatric clinics to assess and manage complex
health issues.

3. Hospital settings: SGA can be used in

hospital settings to assess older adults' needs
and develop care plans.
CHALLENGES
1. Time and resource constraints: Conducting
comprehensive assessments can be time-
consuming and require significant resources.
2. Complexity of geriatric care: Older adults
often have multiple chronic conditions, making
care planning complex.

By incorporating SGA into clinical practice,

healthcare providers can deliver more effective,
patient-centered care to older adults.
B. Health history
Assessing the health history of an older adult
involves gathering information about their medical
past, current health status, and lifestyle. This
comprehensive assessment helps healthcare
providers understand the
individual's needs and develop effective care
plans.
KEY COMPONENTS OF HEALTH HISTORY
ASSESSMENT
1. Medical history: Review of past medical
conditions, surgeries, and hospitalizations.
2. Current health status: Evaluation of current
symptoms, medications, and health concerns.
prescription and over-the-counter medications,
including dosages and potential interactions.
4. Allergies and sensitivities: Identification of any
allergies or sensitivities to medications, foods, or
environmental factors.
5. Lifestyle factors: Assessment of diet, exercise,
smoking, and substance use.
6. Social history: Evaluation of social support, living
situation, and access to resources.
7. Cognitive and functional assessment: Evaluation
of cognitive function, activities of daily living (ADLs),
and instrumental activities of daily living (IADLs).
IMPORTANCE OF HEALTH HISTORY
ASSESSMENT
1. Accurate diagnosis: A comprehensive health
history helps healthcare providers make
accurate diagnoses.
2. Effective care planning: Understanding an
individual's health history informs the
development of personalized care plans.
3. Medication management: A thorough
medication review helps prevent adverse
interactions and ensures safe medication use.
4. Preventive care: Identifying health risks and
lifestyle factors enables healthcare providers to
recommend preventive measures.
HERE ARE THE STEPS TO ASSESS THE HEALTH
HISTORY OF AN OLDER ADULT:
STEP 1: PREPARE FOR THE ASSESSMENT
Choose a comfortable setting: Select a quiet,
comfortable setting where the older adult feels
at ease.
Ensure privacy: Ensure the assessment takes
place in a private setting to encourage open
discussion.
Gather necessary tools: Gather any necessary
assessment tools, such as a health history
questionnaire.
STEP 2: INTRODUCE YOURSELF AND EXPLAIN THE
PURPOSE
Introduce yourself: Clearly introduce yourself
and your role in the assessment process.
Explain the purpose: Explain the purpose of
the health history assessment and how it will be
used.
Establish rapport: Establish a rapport with the
older adult to build trust and encourage open
communication.
STEP 3: GATHER INFORMATION
Ask open-ended questions: Ask open-ended
questions to gather information about the
older adult's medical history, current health
status, and lifestyle.
Use a health history questionnaire: Use a
standardized health history questionnaire to
ensure a comprehensive assessment.
Review medical records: Review medical records
to gather additional information about past
medical conditions
 and treatments.

STEP 4: ASSESS COGNITIVE AND MENTAL HEALTH

Use standardized assessment tools: Use
standardized assessment tools, such as the
Mini-Mental State Examination (MMSE), to
evaluate cognitive function.
Assess mental health: Assess mental health
status, including symptoms of depression or
anxiety.
STEP 5: DOCUMENT FINDINGS
Accurately document findings: Accurately
document the findings from the health history
assessment.
Include relevant information: Include relevant
information about the older adult's medical
history, current health status, and lifestyle.
Use clear and concise language: Use clear and
concise language when documenting findings.
STEP 6: DEVELOP A CARE PLAN
Develop a personalized care plan: Develop a
personalized care plan based on
the findings from the health history
assessment.

Prioritize health issues: Prioritize health issues

and develop strategies to address them.
Involve the older adult and their family:
Involve the older adult and their family in the
care planning process to ensure their needs
and preferences are met.
CHALLENGES
1. Complexity of geriatric care: Older adults
often have multiple chronic conditions,
making care planning complex.
2. Cognitive impairment: Some older adults
may have difficulty providing accurate
information due to cognitive impairment.
3. Communication barriers: Healthcare
providers must be aware of potential
communication barriers, such as hearing or
vision loss.
C. PHYSICAL ASSESMENT

A physical assessment of an older adult involves

evaluating their physical health and function. This
assessment helps healthcare
providers identify potential health issues,
develop effective care plans, and promote
overall well-being.

KEY COMPONENTS OF PHYSICAL ASSESSMENT

1. Vital signs: Measuring temperature, blood
pressure, pulse, respiratory rate, and oxygen
saturation.
2. Body systems assessment: Evaluating the
cardiovascular, respiratory, gastrointestinal,
musculoskeletal, and neurological systems.
3. Functional assessment: Assessing activities of
daily living (ADLs) and instrumental activities of daily
living (IADLs).
4. Mobility and balance assessment: Evaluating
gait, balance, and risk of falls.
5. Sensory assessment: Evaluating vision,
hearing, and other sensory functions.
Techniques Used in Physical Assessment
1. Inspection: Observing the patient's overall
appearance, posture, and movement.
2. Palpation: Using touch to assess body structures,
such as pulses, masses, or areas of tenderness.

3. Percussion: Using percussion techniques to

assess lung sounds, abdominal masses, or other
body structures.
4. Auscultation: Listening to body sounds, such
as heart or lung sounds.
IMPORTANCE OF PHYSICAL ASSESSMENT
1. Early detection of health issues: Physical
assessment helps identify potential health
problems early, allowing for timely interventions.
2. Development of effective care plans: A
comprehensive physical assessment informs the
development of personalized care plans.
3. Promoting functional ability: Assessing
functional ability helps healthcare providers
develop strategies to promote independence and
mobility.
Conducting a comprehensive physical assessment
of an older adult involves several steps to ensure a
thorough evaluation of their health status. Here’s
a structured approach to performing this
assessment:
1. PREPARATION

• Gather Equipment: Ensure you have all

necessary tools, including a stethoscope,
sphygmomanometer, thermometer, penlight,
otoscope, and any other relevant instruments
 • Create a Comfortable Environment: Ensure
privacy, adequate lighting, and a comfortable
temperature in the assessment area.

• Review Medical History: Familiarize

yourself with the patient's medical history,
medications, and any specific concerns they
may have.
2. INTRODUCTION

• Identify Yourself: Introduce yourself and explain

your role.

• Obtain Consent: Explain the purpose of the

assessment and obtain verbal consent.

• Build Rapport: Engage in a brief conversation to

help the patient feel at ease.

3. GENERAL SURVEY
 • Observe Overall Appearance: Note the patient's
hygiene, grooming, posture, and mobility.

• Assess Vital Signs: Measure blood pressure,

heart rate, respiratory rate, temperature, and
oxygen saturation.

• Evaluate Pain Level: Ask about any pain or

discomfort using a standardized pain scale.
4. HEAD-TO-TOE ASSESSMENT

▎A. Neurological Assessment

• Level of Consciousness: Assess alertness and
orientation (person, place, time).
• Cranial Nerves: Check for function of cranial
nerves through simple tests (e.g., facial symmetry,
visual acuity).
• Motor Function: Assess strength and
coordination (e.g., hand grips, finger-to-nose test).

• Reflexes: Check deep tendon reflexes if

indicated.
B. CARDIOVASCULAR SYSTEM

• Heart Sounds: Auscultate heart sounds for rate,

rhythm, and any abnormal sounds (e.g., murmurs).

• Peripheral Pulses: Palpate peripheral pulses

(radial, dorsalis pedis, posterior tibial).

• Capillary Refill: Assess capillary refill time in

fingers and toes.
C. Respiratory System

• Breath Sounds: Auscultate lung fields for normal an

abnormal breath sounds.
• Respiratory Effort: Observe for use of accesso
muscles or signs of distress.
D. GASTROINTESTINAL SYSTEM
• Abdominal Inspection: Inspect for distention, scar
or abnormalities.
• Auscultation: Listen for bowel sounds in a
quadrants.
• Palpation: Gently palpate the abdomen f
tenderness or masses.
E. GENITOURINARY SYSTEM

• Urinary Function: Inquire about urinary

habits, incontinence, or changes in urinary
patterns.

• Pelvic Examination: If appropriate and

consented, perform a genital examination to
assess for any abnormalities.

Screening for Health Issues

• Sexual Health: Older adults may
experience changes in sexual function,
libido, or satisfaction. Assessing the
genitals can help identify issues such as
erectile dysfunction in men or vaginal
dryness in women.

• Infections: Older adults are still at risk

for sexually transmitted infections (STIs),
and a genital examination can help
identify signs of infection or other
abnormalities.
Cancer Screening

• Prostate Cancer: In men, a digital

rectal exam (DRE) may be performed to
screen for prostate abnormalities.

• Cervical and Ovarian Cancer: In

women, a pelvic examination can be
crucial for cervical cancer screening
(Pap smear) and to assess for other
gynecological issues.
Urinary Health
• Incontinence: Many older adults experience
urinary incontinence, which can have significant
implications for quality of life. Assessing the genital
area can help evaluate any underlying issues.
• Prostatitis: Men may have conditions like
prostatitis that can affect urinary function.
Skin Integrity

• Skin Changes: The genital area can show signs of

skin changes, infections, or irritation that may not be
apparent elsewhere. This is particularly important in
individuals with limited mobility or who are bedridden.

Psychosocial Factors

• Body Image and Self-esteem: Changes in genital

health can impact body image and self-esteem, which
are important aspects of mental health in older
adults.
 • Communication about Sexuality: Discussing
genital health can open up conversations about
sexual health, intimacy, and relationship
dynamics.
CONSIDERATIONS

• Patient Comfort: It’s essential to approach

this assessment with sensitivity and respect.
Ensure the patient is comfortable and
understands the purpose of the examination.
• Cultural Sensitivity: Be aware of cultural attitudes
towards genital examinations, as they may vary
widely among individuals.

• Consent: Always obtain informed consent before

performing any examination of the genital area.

F. MUSCULOSKELETAL SYSTEM

• Range of Motion: Assess active and passive

range of motion in major joints.

• Strength Assessment: Evaluate muscle strength

in upper and lower extremities.
G. INTEGUMENTARY SYSTEM

• Skin Assessment: Inspect skin for color, texture

turgor, lesions, or signs of pressure ulcers.

• Nail Assessment: Check nails for color, shape, and

integrity.

5. FUNCTIONAL ASSESSMENT

• Activities of Daily Living (ADLs): Assess the ability

to perform basic self-care tasks such as bathing
dressing, eating, and toileting.
 • Instrumental Activities of Daily Living (IADLs):
Evaluate more complex tasks such as managing
finances, medication management, shopping, and
transportation.
▎6. PSYCHOSOCIAL ASSESSMENT
• Mental Health Screening: Inquire about mood,
anxiety levels, and cognitive function (e.g., memory).
• Social Support: Discuss the patient's support
system and living situation.
• Advance Directives: Ask about any advance care
planning or directives.
7. CLOSING THE ASSESSMENT
• Summarize Findings: Provide a brief summary
of your findings to the patient.
• Answer Questions: Allow time for the patient
to ask questions or express concerns.
• Plan Follow-Up Care: Discuss any necessary
follow-up appointments or referrals based on the
assessment findings.
▎8. DOCUMENTATION
• Document all findings accurately in the
patient’s medical record, including vital signs,
observed behaviors, and any concerns raised by
the patient.
CONSIDERATIONS IN OLDER ADULTS
1. Age-related changes: Healthcare providers must
be aware of age-related changes that can affect
physical function, such as decreased muscle mass
or bone density.
2. Comorbidities: Older adults often have multiple
chronic conditions, which can impact physical
function and overall health.
3.Medications: Healthcare providers must consider
the potential impact of medications on physical
function and overall health.
D. GERIATRIC ASSESMENT (FUNCTIONS AND
COGNITION)
Assessing functional and cognitive abilities is crucial
in geriatric care. Here's an overview:

Functional Assessment
1. Activities of Daily Living (ADLs): Evaluating ability
to perform basic self-care tasks, such as:
- Bathing
- Dressing
- Grooming
- Toileting
- Feeding
2.Instrumental Activities of Daily Living (IADLs):
Assessing ability to perform complex tasks, such as:
- Managing finances
- Cooking
- Cleaning
- Shopping
- Managing medications

COGNITIVE ASSESSMENT
1. Memory: Evaluating short-term and long-term
memory.
2. Attention and concentration: Assessing ability to
focus and maintain attention.
3.Language and communication: Evaluating
ability to understand and express language.
4.Executive function: Assessing ability to plan,
organize, and problem-solve.
Assessment Tools
1. Katz Index of Independence in ADLs: A widely
used tool to assess ADLs.
2. Lawton Instrumental Activities of Daily Living
(IADL) scale: A tool to assess IADLs.
3. Mini-Mental State Examination (MMSE): A
widely used tool to assess cognitive function.
4.Montreal Cognitive Assessment (MoCA): A tool
to assess cognitive function, including executive
function.
IMPORTANCE OF ASSESSMENT
1. Identifying functional decline: Early
detection of functional decline can inform
care planning and interventions.
2. Developing personalized care plans:
Assessing functional and cognitive abilities
helps healthcare providers develop tailored
care plans.
3. Promoting independence: Identifying areas
of strength and weakness can inform
strategies to promote independence and
functional ability.
CONSIDERATIONS
1. Comprehensive assessment: A comprehensive
assessment should include both functional and
cognitive evaluations.
2. Multidisciplinary approach: A multidisciplinary
team, including healthcare providers, therapists, and
social workers, can provide a comprehensive
understanding of the individual's needs.
3.Cultural sensitivity: Assessments should be
culturally sensitive and take into account the
individual's values and preferences.
By assessing functional and cognitive
abilities, healthcare providers can
develop a deeper understanding of an
older adult's needs and provide high-
quality, patient-centered care.
INDEX NUMBERS

NMCBLPHN220012
NMCBLPHN220097
NMCBLPHN220067
NMCBLPHN220037
NMCBLPHN220078
NMCBLPHN220058
NMCBLPHN220014