Discussion: Assessment Tools
As an advanced practice nurse, it is essential to understand the various tools used in the assessment of the patients in geriatric care. A proper understanding of the diagnostic tool makes it possible to know the prognosis of the patient’s condition thereby drawing up a care plan that will support the elderly patient appropriately. The initial post identifies the appropriate assessment tools for Mr. Smith’s condition described in case study 1.
According to case study 1, Mr. Smith suffers from osteoarthritis for which he takes Tylenol for the pain. Besides, he uses a straight cane because he feels pain in the right hip. He says that the pain has significantly increased in six months. As part of the assessment plan, the patient needs a proper assessment of functional ability.
Assessment of Functional Ability
An individual’s functional ability refers to the ease or difficulty with which individual daily living tasks. Due to Mr. Smith’s condition (osteoarthritis), it is essential to assess for activities of daily living (ADL) and instrumental activities of daily living (IADL) (Mohile et al., 2015). ADL constitute basic activities such as dressing, eating, transferring between bed and chair as well as bathing. IADL constitutes activities such as doing house chores, taking medication, and preparing meals among others.
The two assessment tools for ADL and IADL include the Katz index and the Lawton IADL scale. The Katz scale of independence in daily activities focuses on the basic activities of daily living (Arik et al., 2015). In the provided case, an advanced practice nurse to ascertain whether the patient does the activities of daily living dependently or independently. Due to the pain in the patient’s hip, some of the activities of daily living may present a challenge to Mr. Smith. Such activities may include bathing and dressing. However, an advanced practice nurse has to factor in all the activities of daily living during the assessment. Lawton instrumental activities of daily living scale, on the other hand, is self-rated. When assessing the patient using the scale, Mr. Smith can be presented with questions on the ability to perform instrumental activities with or without help. The self-rated questions on IADL come with options such as ‘without help,’ ‘with some help,’ and ‘completely unable.’
The two assessment tools on functional ability are preferred among geriatric patients with difficulties in performing daily activities (Overcash, 2015). Education is one of the factors that can affect the performance of the assessment. Lawton IADL scale requires the patient to have the ability to read. In the case of a language barrier, a translator can be used to help.
References
Mohile, S. G., Velarde, C., Hurria, A., Magnuson, A., Lowenstein, L., Pandya, C., … & Dale, W. (2015). Geriatric assessment-guided care processes for older adults: a Delphi consensus of geriatric oncology experts. Journal of the National Comprehensive Cancer Network, 13(9), 1120-1130.
Arik, G., Varan, H. D., Yavuz, B. B., Karabulut, E., Kara, O., Kilic, M. K., … & Halil, M. (2015). Validation of Katz index of independence in activities of daily living in Turkish older adults. Archives of gerontology and geriatrics, 61(3), 344-350.
Overcash, J. (2015, September). Assessing the functional status of older cancer patients in an ambulatory care visit. In Healthcare (Vol. 3, No. 3, pp. 846-859). Multidisciplinary Digital Publishing Institute.