Age-Specific Examination: Special Populations and Older Adults



Age-Specific Examination


Special Populations and Older Adults



Examination Guidelines


Variability exists in knowledge, experience, cognitive abilities, and personality among patients. These differences can affect your interaction. Persons with disabilities and older adults may experience some decline in their abilities, and these changes may not all occur at the same rate. Adaptation to patients’ needs with disabling physical, intellectual, or emotional states (e.g., acute disabling illness, deafness, blindness, depression, psychosis, developmental delays, or neurologic impairments) is necessary.


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Interviewing a patient with a physical disability. Note the uncluttered surroundings; be sure the patient in a wheelchair has room to maneuver.

Some patients may have sensory losses, such as hearing, that make communication more difficult. Position yourself so that the patient can see your face. Speak clearly and slowly;shouting magnifies the problem by distorting consonants and vowels. For deaf patients who use sign language, use of a sign language interpreter is best. Impaired vision and difficulties with light-dark adaptation are a problem with written interview forms. Large print and lighting that does not glare or reflect in the eyes or individualized assistance is helpful.


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Interviewing a patient with the help of an interpreter. Someone other than a family member should act as interpreter to bridge the language difference between the health care provider and the patient.

The patient has most often learned the best way to be transferred from a wheelchair or bed to another site or to a different position. Consult patient about this.


Let a hearing-, speech-, or vision-impaired patient guide you to the best communication system for your mutual purposes.


Bowel and bladder concerns are common to many individuals with disabilities and should be given the necessary attention during the examination process.



Cognitive Assessment


Some older adults or individuals with intellectual delay may be confused or experience memory loss, particularly for recent events. Take whatever extra time is needed. Ask short (but not leading) questions, and keep your language simple. Consult other family members to clarify discrepancies or to fill in the gaps. When necessary, use other health care professionals involved in care and the patient’s record as resources for a more complete background.


Mental status is assessed continuously throughout the entire interaction with a patient by evaluating the patient’s alertness, orientation, cognitive abilities, and mood. Observe the patient’s physical appearance, behavior, and responses to questions asked during the history (see figure, p. 276). Evaluate the patient’s mental status throughout the encounter (see Chapter 3).


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During the initial greeting, observe the patient for behavior, emotional status, grooming, and body language. Note the patient’s body posture and ability to make eye contact.

Related posts:

  1. The History
  2. Mental Status
  3. Heart
  4. Musculoskeletal System

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Apr 2, 2017 | Posted by in NURSING | Comments Off on Age-Specific Examination: Special Populations and Older Adults

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