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1/4/14

Geriatric Assessment Pearls

General Guidelines
■ Be mindful that the elderly may be hard of hearing, but never assume that being elderly automatically makes it hard to hear.
■ Approach and speak to elderly Pts as you would any other adult Pt. It is insulting to speak to the elderly like a child. Speaking slowly is sometimes necessary, but does not indicate decreased intelligence.
■ Eye contact helps instill confidence and, in the presence of impaired hearing, it will help the Pt to better understand you.
■ Be aware that decreased tactile sensation and ROM are both normal changes with aging. Care should be taken to avoid unnecessary discomfort or even injury during an assessment.
■ Be aware of generational differences, especially gender differences (e.g., modesty for females, independence for males).
■ Assess for altered mental states. Use your “3-D Vision.”
■ Dementia: Cognitive deficits (memory, reasoning, judgment).
■ Delirium: Confusion/excitement marked by disorientation to time and place, usually accompanied by delusions and/or hallucinations.
■ Depression: Diminished interest or pleasure in most or all activities.

Age-Related Chan Age-Related Changes and Implicationsges and Implications
Decreased skin thickness
Elderly Pts are more prone to skin breakdown
and should be assessed more frequently
for pressure sores.
Decreased skin vascularity
Altered thermoregulation response can put
the elderly at risk for heat stroke.
Loss of subcutaneous tissue
Decreased insulation can put the elderly at
risk for hypothermia.
Decreased aortic elasticity
Increased diastolic blood pressure.
Calcification of thoracic wall
Obscured heart and lung sounds and
displacement of apical pulse.
Loss of nerve fibers/neurons
Allow for extra time to comprehend, to
learn, and to perform certain tasks.
↓ nerve conduction
Response to pain is altered.
Reduced tactile sensation
Puts Pt at risk for injury to self.

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