Example:

Tool Assessment Data Score & Nursing Interventions to

Analysis Maintain
or Improve Score
Katz’s  Severe arthritis in her Score: 2/6  Encourage the client to assist
Index hands. with bathing activities as
(ADLS)  H/O Rheumatoid Analysis: much as she can.
Arthritis Dependent on  Minimize bed baths and offer
 Sees a rheumatologist assistance with more showers allowing the
every 3 months. some ADL’s client to control the shower
 “I would prefer to have including head if she can; ensure
a shower every other [what]. assistance with the shower is
day, rather than twice a continuous.
week.”  Allow the client to pick out
 Inability to dress her clothes each morning.
herself.  Provide assistance with
 “My hands aren’t as dressing.
nimble as they used to  Suggest purchasing clothing
be.” with large buttons or zippers
 etc. and/or magnets for ease.
 etc.
 Geriatric Assessments
Student Name: Clinical Advisor:
Tool Assessment Data Score & Analysis Nursing Interventions to Maintain
or Improve Score
SPICES  S: Sleep disruption: due to Frequent Score: 
bathroom visits through the night, Analysis:
minimally three times a night.
 P: Difficulty eating due to feeling
overwhelmed during feeding time
“They give me too much food”
 C: Urinary incontinence, tends to leak
between bathroom visits
 C: No evidence of confusion
 E: No evidence of falling risk


Katz Index (ADLs)  Score: 

Analysis:
Lawton’s IADL  Score: 
Analysis:
Assessing Pain in Older  Score: 
Adults Analysis:
The Pittsburgh Sleep  Score: 
Quality Index Analysis:
Mini-Cog  Score: 
Analysis:
Geriatric Depression  Score: 
Scale Analysis:
Hendrich II Fall Risk  Score: 
Assessment Model Analysis:
(including Get Up & Go)
Assessment of Fear of  Score: 
Falling in Older Adults: Analysis:
The Falls Efficacy Scale-
International (FES-I)
Assessment of  Score: 
Spirituality in Older Analysis:
Adults:
FICA Spiritual History
Tool
Nursing Diagnosis
-Write one two-part
wellness or health
promotion nursing
diagnosis with evidence
(AEB) from your data to
support it