functional assessment of older adult

two approaches to functional assessment

1. Individual's self-report about his or her ability to perform tasks 2. Observing his or her ability to perform tasks

AADL

Activities older adults perform as family member, member of society and community, including occupational and recreational activities

katz index

Based on concept of physical disability and is intended to measure physical function in older adults and the chronically ill Activities assessed are bathing, dressing, toileting, transferring from bed to chair, continence, and feeding

functional assessment

Basis for care planning, goal setting, and discharge planning Needed for eligibility to obtain services, such as durable medical equipment, home modifications, and inpatient or outpatient rehabilitation services

altered cognition in older adults

Dementia Delirium Depression

ADL;Activities of daily living

Eating Bathing Grooming (washing, combing hair, shaving, cleaning teeth, dressing) Toileting Walking, including propelling a wheelchair, using stairs Transferring, such as bed to chair

lawton

IADL

formal support

Include programs such as social welfare and other social service and health care delivery agencies such as home health care

informal support

Includes family and close long-time friends, and is usually provided free of charge Services provided include tasks such as shopping, bathing, feeding, and paying bills

AADL

Physical Performance Test (PPT) Performance Activities of Daily Living (PADL) Up and Go Test

environmental assessment

Physical environment: Observations to determine safety Falls: Nearly 30% of older adults fall in the community Older adult drivers: 8% of all traffic injuries and 18% of all pedestrian fatalities Sleep: Screening tools to measure sleep pattern Spiritual assessment: Individualized inquiry Special considerations: May require more time to examine Cultural considerations: May impact care and influence decision making

functional ability

Refers to one's ability to perform activities necessary to live in modern society Includes driving, using telephone, and performing personal tasks, such as bathing and toileting

The nurse realizes that the patient at the highest risk for falls the patient: 1.with a history of myocardial infarction. 2.who uses a cane to ambulate. 3.who has to climb up a flight of steps to get to the bathroom. 4.who had a hip replacement 2 months ago.

The correct answer is 2. A patient who walks with a cane is at a higher risk for falls due to his or her dependency on the assistive device and gait imbalance. Answer 1 is incorrect because myocardial infarction does not affect gait. Answer 3 is incorrect; however, climbing steps to go to the bathroom does put the patient at a higher risk than if the bathroom were on the same level. Answer 4 is incorrect; however, having a hip replacement that is less than 6 weeks old may increase the patient's risk of falls.

The nurse is assessing the patient's ability to bathe and dress herself. The nurse knows this type of assessment is considered: 1. the Mini-Cog. 2. independent activities of daily living. 3. dependent activities of daily living. 4. activities of daily living.

The correct answer is 4. This assessment is part of the activities of daily living (ADL) assessment. Answer 1 is incorrect because the Mini Cog is a cognition assessment. Answer 2 is incorrect because the independent activities of daily living (IADLs) include shopping, handling finances, housekeeping, and so on. Answer 3 is incorrect because there is no such type of assessment.

IADL;Instrumental activities of daily living

include shopping, meal preparation, housekeeping, laundry, managing finances, taking medications, and using transportation

functional status

older adults may move continuously through varying stages of independence and disability Lack of social support or safe physical setting are environmental issues affecting functional status and ability to live independently