An Overview of Elderly Population Assessments

As life expectancy increases, there is a high demand for healthcare needs for elderly Americans. According to Population Reference Bureau (PRB), aging Americans are projected to increase to more than 98 million by the year 2060 (Mather, 2016). The growing number of elderly faces normal aging challenges which puts them at a high risk for developing health related problems like chronic and acute illness, cognitive health, mental health, physical injury, malnutrition, sensory impairment, self-care and incontinence (Smith, 2016). It is important to continuously assess the elderly population and identify their needs to “improve health, function, and quality of life” (HealthyPeople2020).

Elderly Assessments

On September 27, 2018, I conducted an assessment interview along with two of my peers at Warwick Forest utilizing specialized tools to address and identify elderly healthcare needs. Our client was elderly male who has been living in the facility for almost 3 years.

SPICES

We started our interview with SPICES assessment tool. The acronym, SPICES, stands for each category that address the issues in sleep disorders, eating or feeding, incontinence, confusion, falls and skin breakdown. The tool can be used to assess healthy and frail older adults requiring nursing interventions (Fulmer & Wallace, 2012). Our client denied any of the categories but evidence of fall. He stated a history of fall and uses walker. When we reviewed his medical history, we found several histories of falls but the client seems to only remember the most recent fall.

Katz

The second assessment tool is the Katz Index of Independence in Activities of Daily Living (ADL). The tool assess functional status to evaluate the client’s ability to perform ADL’s like bathing, dressing, toileting, transferring in and out of bed or chair, complete self-control with urination and defecation and feeding. Each activity gives a score of 1 for independent activities and 0 for activities requiring supervision, direction, personal assistance or total care (Shelkey & Wallace, 2012). The client was able to perform all activities without assistance and scored a total of 6 which identifies the client as independent.

Lawton

Another functional status assessment tool is Lawton Instrumental Activities of Daily Living (IADL) Scale. This particular assessment is useful to identify elderly needs in maintaining their finances, medication management, food preparation, housekeeping and laundering their clothes Graf, 2013). According to the client, he is able to use wired telephones and make calls to his cousin almost everyday who helps him with his finances. He knows the number to dial but finds it hard to use smart portable telephones. He also stated he is able to perform all instrumental activities without assistance. But since he lives in an assisted facility, the client receives some assistance with housekeeping and transportation and utilizes complete assistance with shopping, food preparation, laundry and medication management. The client scored 1 on each categories of ability to use the telephone, housekeeping, transportation and ability to handle finances. He scored 0 on each categories of shopping, food preparation, laundering and medication management which indicates the need for assisted living.

MMSE

The Mini-Mental State Examination (MMSE) screens for cognitive status. The tool ask 11-questions regarding orientation of time and place, registration of words, attention and calculating, recall of words, language and visual construction with an overall maximum score of 30 (Kulowicz & Wallace, 1999). The client scored 27 out of 30 deducting points for not knowing the day of the week and only remembering one of the three words in language questions. Overall, the client’s cognitive function is within normal limits. There is no indication of cognitive impairment and has low odds of dementia.

Conclusion

As normal aging occurs in elderly population assessments such as SPICES, Katz, Lawton, and MMSE are tools that provides information necessary to address issues and develop interventions according to their needs. Prior from arriving at the site, I reviewed the activity to prepare myself on how to execute the interview and made sure I understand the difference between normal to abnormal findings. The elderly client participated in the 12 minutes interview without any hesitations which strengthen my confidence to conduct the activity. He was pleasant and seemed certain with his answers. After reviewing his chart, the document stated he had fallen a few times before but the client only remembers the most recent fall during the interview.

The medication chart listed five medications the client is currently taking including Aricept. My weakness during this interview was my accent. Since English is not my first language, I found myself repeating the questions to the client because he was unable to understand my accent. It could also be that the client is hard of hearing related to age. I am continuously working on my accent and grammar by reading books and watching only English movies. Overall, my experience with the activity was pleasantly educating. I think it will help me to prepare for the final assessment competency.