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HEALTH ASSESSMENT OF ELDERLY

Introduction:-
Health assessment of elderly is very essential for rendering need based care. It implies their
detailed investigation in terms of physical, mental, social and spiritual health and wellbeing; formal
and informal social support and economic resources; physical environment; nutrition status; life
style including exercise and use of drugs including alcohol and tobacco.
The need for such comprehensive assessment arises because of potential or actual
breakdown of independent living due to aging process, vulnerability, multiple pathology, harmful
effects of drugs, inadequate or lack of social and economic support etc.

Health assessment by multidisciplinary team:-


The comprehensive assessment of elderlies requires multidisciplinary team approach because of
its complex nature. The members who can be included are:-
 Physician
 Nurse
 Social worker
 Clinical psychologist
 Nutritionist
 Phychiatrist
 Spiritual leader
 Family member and/or significant other
The composition of the team will vary according to circumstances. By and large, the team consists
of a physician, a nurse and a social worker who may not be there at some places. Other members
who may be included are a physiotherapist and an occupational therapist. Some other members
who may be involved from time to time are psychotherapist, clinical psychologist, speech therapist
and clinical specialists.

Purposes:-
The purposes of comprehensive assessment of elderlies by the multidisciplinary team are:
 to assess health and functional status
 to identify potential and actual problems
 to determine health needs and develop programme of actions to be implemented to meet
their needs.
 to identify the clinical problems.
 to assess risk of preventable disorders.
Objectives:-
The objectives of comprehensive assessment include:
 to prevent breakdown of independent living
 to deal with potential problems of breakdown for independent living
 to deal with actual breakdown (problems) of independent living
 to support and rehabilitate.

CLASSIFICATION OF ELDERLY(WHO) :

 OLDER/ ELDERLY PERSON = 60-79


 OLDEST OLD = 80-99
 CENTENARIAN = 100-109
 SUPER CENTENRIAN= 110 and above
TECHNIQUES OF DATA COLECTION: Techniques used are

 Interview
 Observation
 History taking
INSTRUMENTS USED DURING HEALTH ASSESSMENT:

 Sphygmomanometer
 Glucometer
 Thermometer
 Telequist chart
TOTAL NUMBER OF HOUSES : 25

TOTAL ELDERLY POPULATION: 10

 MALES: 6
 FEMALES: 4
TABLE 1

Frequency and percentage distribution of elderly according to age and gender

N=25

Frequency Percentage
Gender (n) (%)
Male
 60-79 5 20
 80-99 1 4
 100-109 00 00

 110 and above 00 00


00 00

Female
 60-79 4 16
 80-99 00 00
 100-109 00 00

 110 and above 00 00

Table 1(figure 1) depicts that out of total population of elderly, 24% were males, out of them
20% were belonged to 60- 79 age group followed by 4% were belonged to age group of 80- 99.
On other hand among total elderly population, 16% were females, all of them, 16% were
belonged to 60- 79 age group.
Table 2

Frequency and percentage distribution of elderly population according to level of


education

N=25

Males (n=31) Females(n=19)


Educational
level Frequency (n) Percentage (%) Frequency (n) Percentage (%)
Illiterate 03 12 03 12
Primary 03 12 01 04
Middle 00 00 00 00
Secondary 00 00 00 00
education
Senior secondary 00 00 00 00

Graduate 00 00 00 00
Post- graduate 00 00 00 00

Table 3 (figure 3) depicts that among males, 12% were illiterate, 12% had primary education. On
other hand among females, 12% were illiterate, 4% had primary education.
Table-4
Frequency and percentage distribution of elderly population according to head to toe
assessment

N=25

MALE FEMALE
HEAD TO TOE ASSESSMENT
(%) (%)
SCALP
 Clean 06 03
 Not clean 00 01
HEAD
Dandruff
 Present 00 02
 Not present 06 02
Pediculosis
 Present 00 00
 Not present 06 04
Colour of hair
 Grey 03 02
 Black 02 01
 White 01 01
EYES
Discharge
 Present 00 00
 Not present 06 04
Conjunctiva
 Pale
 Pink 04 02
 Dry 02 02
Vision 00 00
 Normal
02 01
 Shortsightedness
02 02
 Longsightedness 01
02
Eyelashes
 Present 06 04
 Absent 00 00
 Dryness 00 00
 Sticky 00 00
MOUTH
Colour of tongue
 Pink
 Patchy tongue 02 01
 Stomatitis 04 03
Dental caries 00 00
 Present
 Absent 11 05
Teeth 89 95
 Dentures
 Presence of teeth 32 34
 Absence of teeth 12 12
NECK 56 54
Lymph nodes
 Present
 Absent 55 43
Range of motion 45 57
 Present
 Absent 65 62
EXTREMITIES 35 38
Range of motion
 Present
 Absent 59 32
Flexion 41 68
 Present
69 32
 Absent
31 68
Extension
 Present
 Absent 33 23
SKIN 67 77
Wrinkled
 Present
 Absent 82 67
Dryness 18 33
 Present
 Absent 75 80
Thinned skin 25 20
 Present
 Absent 77 82
23 18

Table (4) depicts the head to toe examination which shows that among elderly male population
43% were having clean scalped and 57% were having not cleaned scalp.In head 41% and 2%
were having dandruff and pediculosis and remaining 59% and 98% having absence of dandruff
and pediculosis.54%,30%and 16% were having grey, white and black hair colour. 65% and 35%
were having presence of discharge and absence of discharge respectively. 45.5% were having pink,
51% were having dry and remaining 3.5% were having pale conjunctiva. 34% were having normal
eyesight and longsightedness and remaining 32% were having shortsightedness.39% were having
eyelashes and 7% were having absence of eyelashes and 34% were having dryness and 20% were
having sticky eyelashes. 54% were having the patchy tongue,27% were having pink colour and
19% were having the stomatities.89% were having absence of dental caries where 11% were
having presence of dental caries.56% were having absence of teeth ,32% were wearing dentures
and 12% having their own teeth.55% were having lymph nodes in neck. 65% were having and
35% were having absence of range of motion in neck.59% were having range of motion in
extremities and 41% were having absence of range of motion in extremities.69% were having
flexion and 31% were having absence of flexion in extremities. 33% were having extension in
extremities.82% were having wrinkled skin. 75% were having dried skin and 77% were having
thinned layer of skin.

Among elderly female population 49% were having clean scalped and 51% were not having
cleaned scalp. In head 33% and 8% were having dandruff and pediculosis and remaining 67% and
92% having absence of dandruff and pediculosis. 67%,23%and 10% were having grey, white and
black hair colour. 65% and 35% were having presence of discharge and absence of discharge
respectively. 35.5% were having pink, 51% were having dry and remaining 13.5% were having
pale conjunctiva. 12% were having normal eyesight and 45% longsightedness and remaining 43%
were having shortsightedness. 45% were having eyelashes and 2% were having absence of
eyelashes and 31% were having dryness and 22% were having sticky eyelashes. 53% were having
the patchy tongue, 38% were having pink colour and 9% were having the stomatities.95% were
having absence of dental caries where 05% were having presence of dental caries.54% were having
absence of teeth ,34% were wearing dentures and 12% having their own teeth.57% were having
lymph nodes in neck. 62% and 35% were having presence and absence of range of motion in neck
respectiely.32% were having range of motion in extremities and 68% were having absence of range
of motion in extremities.68% were having flexion and 31% were having absence of flexion in
extremities. 23% were having extension in extremities.67% were having wrinkled skin. 80% were
having dried skin and 82% were having thinned layer of skin.
Table- 3

Frequency and percentage distribution of elderly population according to current


systematic health problems

N=50

Males (n=31) Females(n=19)

Percentage (%) Percentage (%)


Health Problems

1. Nervous system
 Disorientation 28 18
 Alziemer’s disease 14 18
25 20
 Depression
12 12
 Parkinson disease
21 32
 Normal

2. Integumentary system
11 34
 Pruritis
22 26
 Redness
33 10
 Edema 02 10
 Eczema 32 20
 Normal

3. Respiratory System
 Asthma 34 23
 Common cold 26 32
 Pulmonary tuberculosis 10 33
 Normal 30 12

4. Cardiovascular system
 Hypertension 43 53
 Hypotension 27 32
 Myocardial infarction 11 13
 Normal 19 02
5. Endocrine system
 Diabetes mellitus 47 33
 Hyperthyroidism 23 33
 Hypothyroidism 10 12
 Normal 20 22

6. Gastrointestinal system
 Constipation 43 43
 Diarrhoea 25 23
09 14
 Peptic ulcer
23 20
 Normal

7. Musculoskeletal system
 Osteoporosis 43 23
 Rheumatoid arthritis 23 47
 Normal 34 30

8. Genitourinary system
 Renal calculi 23 33
 Incontinence of urine 47 47
 Normal 30 20

9. Sensory system
 Cataract 21 20
 Glaucoma 10 12
 Hearing loss 25 31
 Tactile hallucinations 12 10
 Vision loss 04 17
28 10
 Normal

Table 3 depicts the current systematic health problems of elderly population among males health
problem related to the nervous system 28% were having disorientation problem, 25% were
suffering from depression,14% were having alzeimer’s disease, 12% were having Parkinson
disease remaining 21% were having no problem related to nervous system. In integumentary
system 33% were having edema, 22% were suffering from redness over skin, 11% were having
prurities and 2% were having eczema whereas 32% of males were having no problem related to
the integumentary system. In respiratory system 34% were suffering from asthma, 26% were
having common cold problem, 10% were having pulmonary tuberculosis whereas 30% were
having no problem related to the respiratory system. In cardiovascular system 43% were suffering
from hypertension, 27% were having hypotension, 11% were having myocardial infarction and
19% were those who having no problem related to the cardiovascular system. In endocrine system
47% were suffering from diabetes mellitus, 23% were having hyperthyroidism problem and 10%
were having hypothyroidism and 20% were having no problem related to endocrine system. In
gastrointestinal system 43% were having constipation problem , 25% were having diarrhea, 9%
were having complain about peptic ulcer. In musculoskeletal system 43% were having
osteoporosis, 23% were having rheumatoid arthritis and 34% were having no problem. In
genitourinary system 23% were having renal calculi problem, 47% were having incontinence of
urine and 30% were having no problem related to this system. In sensory system 25% were having
problem of hearing loss, 21% were having cataract, 12% were having tactile hallucination, 10%
were having glaucoma, 4% were having problem of vision loss and remaining 28% were normal.

Among females health problem related to the nervous system 20% were suffering from depression
,18% were having disorientation problem and disorientation respectively, 12% were having
Parkinson disease remaining 32% were having no problem related to nervous system. In
Integumentary system 34% were having prurities , 26% were suffering from redness over skin,
and 10% were having eczema and edema respectively whereas 20% of females were having no
problem related to the integumentary system. In respiratory system 33% were having pulmonary
tuberculosis, 32% were having common cold, 23% were suffering from asthma whereas 12% were
having no problem related to the respiratory system. In cardiovascular system 53% were suffering
from hypertension, 32% were having hypotension, 13% were having myocardial infarction and
2% were those who having no problem related to the cardiovascular system. In endocrine system
33% were suffering from diabetes mellitus and hyperthyroidism problem and 12% were having
hypothyroidism and 22% were having no problem related to endocrine system. In gastrointestinal
system 43% were having constipation problem, 23% were having diarrhea, 14% were having
complain about peptic ulcer. In musculoskeletal system 47% were having rheumatoid arthritis,
23% were having osteoporosis, and 20% were having no problem. In genitourinary system 47%
were having incontinence of urine, 33% were having renal calculi problem and 20% were having
no problem related to this system. In sensory system 31% were having problem of hearing loss,
20% were having cataract,17% were suffering from vision loss, 12% were having glaucoma, 10%
were having tactile hallucination and remaining 28% were normal.
SUBJECT: COMMUNITY HEALTH NURSING

SUBMITTED TO : Resp: Mrs Prabhjeet Kaur


(Associate Professor)

SUBMITTED BY: Navjot Kaur


Msc(N) 2nd year
Roll No:- 07

SHRI GURU RAMDASS COLLEGE OF


NURSING HOSHIARPUR
INDEX
Sr.No CONTENT Teacher signature

1 Visit report on leprosy centre


2 Visit report on senior citizen home, jalandhar
3 Pingla ghar, jalandhar
4 De- addiction centre NIMHANS, Bengalore
5 Visit report on government TB Centre,
Hoshiarpur
6 Visit report on SCMHC(Sakalawara
Community Mental Health Centre)
NIMHANS, Bangalore posting
7 Visit report on Cancer Centre, Hoshiarpur
8 Visit report on A.R.T Centre/ STD clinics
Hoshiarpur
9 Protocol for dehydreation
10 Standards for ORS preparation at home
11 Proposal for exhibition
12 Report on exhibition