Functional Assessment of Older Adults Objectives Define functional

Functional Assessment of Older Adults

Objectives ® Define functional assessment and the terminology related to functional assessment. ® Describe some characteristics of functional decline in older persons. 2

Objectives ® Identify comorbid conditions that might impact negatively on the functional status of an older adult. ® Assess function using validated tools. ® Plan strategies to promote / maintain optimal function in older adults. 3

Terminology ® Functional ® Activities Assessment of Daily Living (ADLs) ® Instrumental Activities of Daily Living (IADLs) ® Psychological ® Social functioning 4

Characteristics of functional decline ® Chronic conditions increase with age – arthritis, HTN, heart disease, hearing impairment, cataract ® Older persons use 1/3 of physician resources, 1/4 of total medications prescribed, and 2/5 of hospital admissions 5

Functional decline ® 35. 6 million over 65 (2002) Who are limited by chronic condition? (from 2000 data) ® 26. 1% of those 65 – 74 (young-old) ® 45. 1% of those 75+ (old old) ® 73. 6% of those 80+ (oldest old) 6

Comorbid conditions ® ® ® ® ® Acute illness Alteration in nutrition and / or hydration Chronic illness Delirium Dementia Economics Environment Medications Psychiatric comorbidities – depression Psychological / social stressors 7

Functional assessment tools Katz Activities of Daily Living (ADL) Older American Resources and Services Assessment (OARS) ® Bathing KATZ ADL Try ® Dressing This Assessment ® Toileting Series available on ® Transferring Hartford Institute ® Continence website at ® Feeding www. hartfordign. org 8

Functional assessment tools Lawton Instrumental Activities of Daily Living (IADL) ® Ability to Telephone Mode of Transportation ® Shopping Ability to Handle Finances Responsibility for Own Medication ® Food Preparation ® Housekeeping ® Laundry 9

Functional assessment tools PULSES Profile ® Physical Condition ® Upper Limb Function ® Lower Limb Function ® Sensory Components ® Excretory Functions ® Support Factors 10

Functional assessment tools SPICES ® Sleep Disorders ® Problems ® Incontinence ® Confusion ® Evidence of Falls ® Skin Breakdown SPICES Try This Assessment Series available on Hartford Institute website at www. hartfordign. org 11

Functional assessment tools Timed “Get-up and Go” Test – Ambulation ® Rise from a chair ® Stand still momentarily ® Walk toward the wall ® Turn around ® Walk back to chair ® Turn around ® Sit down 12

Strategies for optimal functioning ® Exercise and physical activity ® Design environments with handrails, wide doorways, raised toilet seats, etc. ® Judicious use of medications ® Regular exam for cancer prevention and other diseases ® Alternatives to restraints 13

Strategies for optimal functioning ® Minimize bed rest ® Optimize nutritional patterns ® Maintain vaccination status ® Provide information to caregivers on causes of functional decline related to acute and chronic conditions. 14

Summary ® Defined functional assessment ® Described functional decline ® Comorbid conditions ® Reviewed assessment tools ® Strategies for optimal functioning 15

QUESTIONS? 16