Care of an older adult client: Nursing

Care of the older adult involves providing holistic care to meet the needs of patients as they mature through adulthood.

Now, your goal when assessing your older patient is to identify common health issues of older adults, and to intervene to promote your patient’s health and safety.

Begin by performing a mental status assessment. Observe their general appearance, posture, and facial expressions as indicators of mental function, and evaluate their level of consciousness and orientation to person, place, and time.

As you talk with your patient, assess their speech patterns, organization of thoughts, and mood. Check for the presence of risk factors for depression, including situations like loss of a spouse, recent retirement, or isolation, as well as problems like pain or insomnia, which can be associated with depression.

During your assessment, be sure to allow adequate time for them to respond to your questions. If your patient’s mental status is altered, adjust your approach accordingly.

Next, assess their mobility and their ability to safely complete their activities of daily living, or ADLs, including bathing, dressing, toileting, and eating.

Be sure they have assistive devices, as needed, like a walker, cane, glasses, or hearing aids. Ask them if they have experienced a recent fall and talk to them about measures to increase safety in their home by removing throw rugs, ensuring adequate lighting, and installing handrails.

Encourage physical activity according to their level of mobility to promote balance and maintain muscle mass. Also, be sure to assess their nutrition and hydration status, including recent weight loss or gain; appetite; the presence of digestive, chewing, or swallowing problems; access to nutritious foods; the ability to prepare food; as well as their daily fluid intake.

In addition, remember to assess for problems with urinary incontinence or bowel elimination. Then assess how they manage their daily medications.

Keep in mind that polypharmacy, or the use of multiple medications to treat various health conditions, is common in older adults, and it can increase the risk of adverse drug reactions that can lead to problems like constipation, diarrhea, or incontinence; mental status problems like confusion and depression; and falls.

Review each medication with your patient, including use of any over-the-counter medications or supplements. Ask them if they know why each medication is prescribed, when to take them, if they take them with or without food, and if they require assistance to safely take their medications.

If needed, encourage them to use colored labels, a pill organizer, or a pill alarm to remind them when to take their medications.

You’ll also want to assess for substance use disorders, by asking questions about frequency of use, and if they use alcohol when they feel lonely or to take their mind off of any problems.

Also, remember to check for and report signs of elder abuse or neglect. After completing your assessment, contact the health care provider for additional support or referrals if assistance is needed in any of these areas.

Okay, as a quick recap.... Care of the older adult involves providing holistic care to meet the needs of patients as they mature through adulthood.

When caring for an older adult, focus your assessment on identifying common health issues of older adults, and developing interventions to promote health and safety.