Assessments and Best Practices in Care of Older Adults

Assessments and Best Practices in Care of Older Adults

Caring for older adults is far more complex than the majority of today’s nurses and other healthcare providers ever learned in school, and than the majority of faculty in any schools of nursing are prepared to teach their students. In fact, lack of knowledge about care of older adults among the teachers, students and working graduates of nursing programs results in inadequate assessment skills-skills that are the foundation of good geriatric care—and ultimately in missed or erroneous diagnoses, treatments that can harm rather than heal, and a reduced quality of life among those 65 years of age and older.

In order to provide resources that will help to fill the gap between knowledge and practice in the care of older adults, the John A. Hartford Foundation has funded the Hartford Institute for Geriatric Nursing (HIGN) at New York University’s College of Nursing, and the American Journal of Nursing, for a project called How to Try This. How to Try This is an initiative that will translate the evidence-based geriatric assessment tools in the HIGN Try This assessment series into cost-free, web-based resources including demonstration videos and a corresponding print series featured in the AJN.

Why is assessment of older adults so important? Illnesses in older people often look different than in younger ones. For instance, younger adults with a urinary tract infection will have many or all of these symptoms: frequent urination, pain from bladder spasms, blood in the urine, and fever. Changes that occur with aging often mask these symptoms that provide early clues to a urinary tract infection. The first sign of a urinary tract infection in an older adult might be confusion or a fall. If the nurse does not have the knowledge and skills to further evaluate the older adult who might fall or become confused, the infection can go untreated and result in overwhelming infection, and possibly death.

Age-appropriate assessments: the foundation for good care of older adults

Assessment has long been recognized as the most important step in determining appropriate care. The Scope and Standards of Gerontological Nursing Practice establishes the professional standards, required nursing knowledge, and the specific nursing skills and abilities against which gerontological nurses are held professionally and legally responsible. These standards define assessment as the first step in managing patients and the basis for developing a comprehensive plan of care.

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