Health Assessment and Screening in the Older Adult

Performing health assessments and health screenings, provide information about a patient's health status and identify those in need of further assessment and care as the nurse caring for older adult patients, you'll use this information to provide patient centered care.

Now, during a health assessment, you'll collect comprehensive health information which typically includes gathering a health history and conducting a physical examination.

Health information can be categorized as either subjective or objective data. Subjective data refers to information the patient states or recounts such as pain level or sleep quality and tends to be obtained during a health history.

On the other hand, objective data is collected during the physical assessment and includes tangible information that's observed or measured like presence of a skin rash or BP readings.

All right. Starting with a health history.

This is where you'll interview your patient to obtain subjective data about their perceived health and factors impacting their health.

Begin by asking about basic identifying information, like name and date of birth. Next, move on to specific data like past medical and surgical history such as previous hospitalizations and surgeries, current medications and personal health habits like diet, physical activity and sleep patterns then you'll discuss the patient's current health status and any pressing health concerns as needed.

Keep in mind that the patient is the preferred information source. However, a family member or caregiver can provide information if your patient has a limited ability to recall or communicate like those with dementia or aphasia during the health history.

Remember to do your best to avoid the use of medical jargon, for example, instead of saying hypertension, say high BP. Also since word recall and response time can slow with age, be sure to speak slowly and clearly and provide your patient with enough time to answer your questions.

Next up is the physical assessment where you'll use inspection, percussion palpation and auscultation to collect objective data about your patient's health status and validate subjective information gathered from health history.

Typically the physical examination is conducted in a head to toe approach, meaning it starts with the head and then moves systematically down the body.

Now, before starting the examination, gather your assessment equipment and ensure the examination room is set up for privacy and comfort.

Also keep in mind that older adults may present with atypical signs and symptoms such as confusion in the presence of an acute infection or vague symptoms like fatigue and nausea rather than chest pain during a myocardial infarction.

Lastly, you may also perform special tests to detect sensory changes like the Snellen test for visual acuity or the mini cog tool to determine mental status and recall.

Ok. Switching gears.

Health screenings are tests or procedures conducted on asymptomatic individuals to identify those who require a more in depth assessment, recognize the presence and risk factors for certain conditions and detect pathologic findings early.

So, prompt referrals and treatment can occur. Health screenings can be conducted during an older adult's annual wellness visit at a community clinic or at a senior center and they come in various formats such as a questionnaire about depressive symptoms, a mammogram for breast cancer detection or a blood draw to measure glucose levels.

Other recommended health screenings for older adults include bone density screenings and colorectal screenings. If concerning findings are identified during a screening, your patient can be referred to the appropriate specialist for additional evaluation and treatment.

Now, although many health screenings are aimed at detecting pathologic conditions, they can also help identify older adults at risk of having health problems related to socioeconomic barriers, like lack of access to nutritious food or safe transportation to the pharmacy.

If you identify any of these barriers, work with the healthcare provider and social worker to support your patient in gaining access to the necessary resources.

All right, as a quick recap, performing health assessments and health screenings provide information about a patient's health status and identify those in need of further assessment and care.

As the nurse caring for older adult patients, you'll use this information to provide patient centered care