Functional Assessment Screening of Older Adults Functional Screening is important because Chronological age is poor indicator of ability.

y. Hospitalized older adults are at high risk for loss of function skills. Environmental constraints (IVs, catheters, side rails) Decreased expectations for performance (ageism) New disabilities or illness

Chronic Pain Medications

When doing an assessment Assess, dont assume. Watch, dont just ask. Obtain baseline information: it is important to know what is normal for this individual. Identify what helpers, equipment, and supports make doing activities of daily life possible.

Loss of functional abilities is a major cause of institutionalization.

ASSESSMENTS: Vision Screening Condition of glasses Snellen chart When was the last eye exam?

The goal of a functional assessment screening is to restore or improve health monitor changes enhance independence identify disabilities screen for issues needing further assessment and referral evaluate the need for community resources and equipment

Minimum is every two years. If diagnosed with diabetes or an eye condition such as glaucoma, eye exams could be as frequent as every 6-12 months. Hearing Cerumen Build up interferes with the conduction of sound.

Functional Assessment Screening Vision / Hearing Mobility (arms, legs) Oral / Nutrition Elimination Cognitive

Hearing aids Check batteries frequently; they last anywhere from less than a week to less than a month. Can cause an increase of cerumen impaction.

Upper Extremities ADL and IADL* Home Environment Social Support Putting on a shirt Getting items off a shelf Combing and washing hair

Lower Extremities Get Up and Go Test Get up from a chair Walk 10 feet Turn around and walk back Sit down again Problems with the above correlate with abnormal gait and increased risk of falling.

Elimination: DRIP D - Delirium, Depression, Dementia R - Retention, Restricted mobility environment and/or

I - Infection, Inflammation, Impaction P - Pharmaceuticals, Polyuria Cognitive Function Delirium onset hours to days

Problems with the above correlate with abnormal gait and increased risk of falling.

Depression onset weeks to months

Oral Screening Inspect the oral cavity and check the condition of teeth the condition and fit of dentures for oral lesions or infections such as candidiasis Remember!

Dementia onset months to years

If an older adult was not confused a few hours or days ago, his or her confusion usually indicates an acute problem that requires prompt evaluation. Tools in Assessing Cognitive Function

Ask Do you have any problems eating or swallowing? When was your last dental appointment?

Mini Mental State Examination (MMSE) Measures orientation, registration, attention, & calculation, short term recall, language, & visuospatial function.

Quadruple As of Nutrition Appearance Does the person look well nourished? Appetite How is the persons appetite? Mini Cog

consists of 3 item recall, & a click drawing test.

Activities of Daily Living Access Ask if need help with activities done every day, such as Ability Ambulation Transfers Bathing and grooming

Does the person have access to funds to buy food? Get to the store?

Can the person prepare own meals? Open cans? Cook safely?

Toileting Eating Dressing

Advance Activities of Daily Living Advance Activities of Daily Living include societal, family and occupational and recreational activities.

TOOLS IN ASSESSING ADL Katz Index of ADL Barthel Index of Activities of Daily Living

Social Support Who would be able to help in case of illness or emergency? What community and family resources are available?

Instrumental Activities of Daily Living address the older adults ability to interact with his or her environment and community. commonly used tool: Lawtons IADL scale

Chronic Pain Do you experience pain that prevents you from doing certain activities?

Ask if need help with activities which are more complex, such as Writing Reading Cooking Cleaning Shopping Doing laundry Going up stairs Using the telephone Outside activities Managing medications Managing money Transportation

Medications What medications do you take? What are the medications for? Do you have any trouble taking them?

Caregivers Being a caregiver is hard work. It is not unusual for a caregiver to neglect his or her own health while taking care of a loved one. Be sure to ask the caregiver how he or she is doing and what ways he or she is using to take care of self. Remember: Preserving, nurturing, measuring, recording, and communicating function are the core of good geriatric care. Functional Assessment Screening of Older Adults was prepared by Catherine Van Son, Ph.D., R.N., for the Older Adult Focus Project, OHSU School of Nursing.

Home Environment Ask if have trouble going up and down stairs. Ask if have had any falls inside or outside of the home. What kinds of safety hazards should you assess that might be present in the home?