Health Assessment Week 11

The tasks necessary for self-care. Typically, ADLs encompass domains of eating/feeding, bathing, grooming (the individual tasks of washing face, combing hair, shaving, cleaning teeth), dressing (lower body and upper body), toileting (bowel and bladder), walking (including propelling a wheelchair), using stairs (ascending and descending), and transferring (such as bed to chair).

been developed since the 1960s, with the goal of measuring functional abilities necessary for independent community living. IADL tasks typically include shopping, meal preparation, housekeeping, laundry, managing finances, taking medications, and using transportation.

--> Lawton and Brody in 1969 to address higher order components of the Katz Index of ADL and to measure the more complex ADLs required for a person to adapt to the environment

Situation, Background, Assessment, Recommendations

based on the concept of physical disability and was intended to measure physical function in older adults and chronically ill patients.

includes definitions of each task to facilitate ease of scoring and has a more comprehensive assessment of mobility than the Index of ADL, rehabilitation settings

developed by a consensus panel of physical medicine and rehabilitation staff and has been widely tested on older adults. It can be administered three ways: by telephone, by in-person interview, and by proxy. It is more sensitive to change than the other ADL instruments, but formal training in its use is necessary, and it is more time consuming

completed by a family member or professional caregiver who is familiar with the abilities of the older adult. It is designed to measure what the patient actually can do versus what he or she might be able to do.

activities that an older adult performs as a family member and a member of society and community; they include occupational and recreational activities. Items concerning self-care, mobility, work (either paid or volunteer), recreational activities/hobbies, and socialization.

a common, life-threatening disordered mental state that, when recognized and treated promptly, is often reversible.

a progressive loss of brain function that can occur with several different diseases such as stroke and brain injury

persistent feelings of sadness or hopelessness, a loss of interest or pleasure in previously enjoyable activities, or a combination of these. It also includes cognitive and physical changes, such as trouble with concentration (which leads to memory problems), disturbed sleep, decreased energy or excessive tiredness, and decreased appetite.

"Prevention and treatment of depression may be one of the most effective interventions aimed at reducing functional decline in an older adult"

consist of informal supports that are accessible to the older adult

Social network (formal, semiformal, informal)

Caregiver assessment

Potential for elder abuse

Environment

Spiritual needs

Psychological abuse: Anything that diminishes a person's sense of dignity, self-worth, or identity

Financial or material abuse: Theft or misuse of the older person's money or property

Neglect

-->Active (intentional withholding of basic necessities of life)

-->Passive (not providing basic necessities because of lack of experience, information, or ability)

Physical abuse: Nonaccidental use of force to coerce or harm; does not have to result in injury

Sexual abuse: Any nonconsensual sexual behaviour, either physical or psychological

Violation of rights: Disregard of basic human and legal rights of the individual

Systemic abuse: Rules, regulations, or policies that harm or discriminate against older adults

Screen for abuse in all older adult patients

Think about risk factors

Ominous danger signs present?

Physical findings

History

Address issue of elder abuse

Report to adult protective services

Manage with prevention and risk factor modification

assess upper body fine motor and coarse motor activities, balance, and mobility.