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The comprehensive health assessment of a geriatric patient should be a clear, organized, and understandable document covering physical assessment findings, the client's health history, and the client's family background (Grand Canyon University [GCU], 2012).

While assessing geriatric patients, nurses should pay attention to hearing and vision loss, as these are two things expected to diminish as clients age (GCU, 2012). Sometimes loss of hearing or vision may be misinterpreted as loss of cognition, so it is important to be able to tell the difference. Loss of cognition is not a normal part of the aging process; if it is noted during the assessment, this may be an indication of delirium, dementia, or depression (GCU, 2012).

Physical changes that may be noted when assessing geriatric patients are: decrease of subcutaneous fat and muscle tone, altered gait, decreased height, and decreased mobility (GCU, 2012). All of these may also indicate lack of proper nutrition, and since elderly clients are at higher risk for inadequate nutrition it is important to assess the client's intake. Caloric needs decrease as clients age, but it is an important assessment finding and nurses should do their best to ensure elderly clients are eating enough.

Skin should be assessed for breakdown, changes in texture, color, rashes, itching, and lesions, bruising, moles, and birthmarks. Skin diseases are common in geriatric patients (GCU, 2012). Remember to use the ABCD acronym when assessing moles (Asymmetry, Border, Color, Diameter) as these can be the first indication of skin cancers (GCU, 2012). While skin loses its elasticity, it may become wrinkled and a little saggy. Check mucous membranes for signs of dehydration.

It is normal for hair to be thin and gray or white in color. Nails should be flat or slightly curved; clubbed nails may indicate heart or pulmonary disease (GCU, 2012).

Another important aspect of the geriatric assessment is to look at all the patient's medications. This is something that may be difficult for many older clients. It is very important to review their medications with them and be sure they know how and when to take each one. Many older patients are on several medications, and when seeing more than one provider ptients can easily be prescribed similar medications at once, or be prescribed medications that may interact with each other. Patients should bring all of their medications to their appointments and go over each one with their provider.

Reference

Grand Canyon University. (2012). Health assessment of the older adult. Retrieved from

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