How to Try This

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.

Good assessment leads to all subsequent care and requires that nurses know:

• on whom assessments should be conducted
• when to conduct the assessment
• how to conduct the assessment
• how to interpret the assessment
• how to communicate the findings to the patient, family, and other members of the healthcare team
• how to use the findings to shape the plan of care.

The links below will take you to the videos and articles specific to each topic. Videos can be watched in their entire format, or in chapters that relate to the specific assessment skills described above. Articles may be printed and copied for educational use without copyright fees.

VIDEOS

JOURNAL ARTICLES

• How to Try This: Assessment of Transient Urinary Incontinence in Older Adults
• How to Try This: Screening Older Adults for Executive Dysfunction
• How to Try This: Screening for Mistreatment of Older Adults
• NCPD How to Try This: Screening for Alcohol Use and Misuse in Older Adults
• How to Try This: Working with Families of Hospitalized Older Adults with Dementia
• How to Try This: Helping Those Who Help Others: The Modified Caregiver Strain Index
• NCPD How to Try This: The Edinburgh Feeding Evaluation in Dementia Scale
• How to Try This: Preventing Aspiration in Older Adults with Dysphagia
• How to Try This: The Hospital Admission Risk Profile
• How to Try This: Using Pain-Rating Scales with Older Adults
• How to Try This: The Mini Nutritional Assessment
• NCPD How to Try This: Pain Assessment in People with Dementia
• How to Try This: The Lawton Instrumental Activities of Daily Living Scale
• How To Try This: Recognition of Dementia in Hospitalized Older Adults
• How To Try This: The Mini-Cog
• How to Try This: Predicting Pressure Ulcer Risk
• NCPD How to Try This: Predicting Patient Falls
• How to Try This: Fulmer SPICES
• How to Try This: Monitoring Medication Use in Older Adults
• NCPD How to Try This: The Impact of Event Scale-Revised
• NCPD How to Try This: Wandering in Hospitalized Older Adults
• How to Try This: The Family Preferences Index
• NCPD How to Try This: Assessment of Sexual Health in Older Adults
• How to Try This: Evaluating Sleep Quality in Older Adults
• How to Try This: Monitoring Functional Status of Hospitalized Older Adults
• How to Try This: Avoiding Restraints in Patients with Dementia
• How to Try This: Communication Difficulties in Hospitalized Older Adults with Dementia
• How to Try This: Delirium Superimposed on Dementia
• How to Try This: Detecting Delirium
• How To Try This: The Geriatric Depression Scale: Short Form

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