The United states census Bureau’s 2009 data revealed that 37% of individuals age 65 and older have disabilities. This includes adults with disabilities who developed in old age and those who lived with disability from birth or have acquired disability in younger or middle years (Hahn, Aronow, Rosario, & Guenther, 2013). According to Ball, Dains, Flynn, Solomon & Stewart, 2014 the primary objective of the clinician when conducting an interview and physical assessment on a patient, is to discover the details about a patient’s concern, explore expectations, identify underlying worries, and believing them which optimizes your ability to help them. It is important to adapt to the needs of all patients of any age with disabling physical or emotional states (Ball et al., 2015).
Selected Patient for Face-to-Face Interview and Assessment
As a clinician building a health history on a 76-year-old Black/African American male with disabilities living in an urban setting. It is important to be sensitive to cultural differences that may exist between you and the patient that can help avoid miscommunication. To build health history based on ethnicity and to avoid stereotype, when necessary clinicians should modify their habits to foster effective communication, because your first meeting with the patient set the tone for success. Also, the clinician should be honest, flexible and have a desire to help (Ball et al, 2015). When you first enter the patient’s, space be respectful by greeting the patient, introduce yourself and state the reason for your visit. Acquire written or verbal consent from the patient to collect health history and to conduct an interview. If possible conduct the interview in an uncluttered quiet area. Have the patients’ health record available and utilize all healthcare professionals involved in this patient’s care. Because the patient may lack the ability to give accurate history, having a family member present with the patient’s permission during the interview helps the patient to be more comfortable to provide needed information (Ball et al., 2015). It is important to sit in front of the patient at eye level, speak slowly, clearly and enunciate each word in the patients view for patients with hearing and visual disability (Ball et al., 2015). To conduct the interview, it is important to have written open-ended questions that are short, uncomplicated and pertinent to the patient to avoid overwhelming and confusion. History on the elderly can be more complex so guiding techniques can be used to obtain important information (Kahn et al., 2013).
Health Related Risk
Frailty is increasingly common among our aging population. Assessing level of frailty is very important, because it has a significant impact on individuals and society with increased risk of dependency, disability, hospitalization, institutional placement, and mortality (Harttgen, Kowal, Strulik, Chatterji, & Vollmer 2013). Frailty is characterized by weakness weight loss and low activity. It is considered an at-risk state caused by age –associated accumulation of deficits (Ball et al., 2015). Functional impairment must be assessed.
Functional Mobility Assessment Screening Tool
Functional assessment must be address for the disabled patient by assessing their health risk. Assessing the patient’s ability to perform activities of daily living (ADL), and cognitive, psychological social and sexual limitation should be completed on all older adults or a disabled patient (Ball et al., 2015). Does the patient has difficulty walking standard distance (0 feet or 2 to 3 blocks), difficulty climbing stairs (up and down), difficulty holding and opening small objects, needs assistance with house-keeping, shopping, money management, meal preparation and assistant eating. Interviewer must keep in mind that the patients will hide or overstate their abilities (Ball et al., 2015).
To build a health history as it relates to ethnicity, information about personal and social history is important to address cultural background, practices, home environment as a youth, education, occupation, current health habits, health coverage and concern about healthcare cost should be collected to avoid the stereotype as they influence the health problem on the patient’s life (Ball et al., 2015). Understanding a person’s life and daily routine can help you to understand how your patient’s lifestyle might affects his healthcare. Also understanding an older patient usual level of functioning and knowing about any recent significant changes are important to providing appropriate healthcare (Paula, Krzysztof, & Ewa, 2018).
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to
physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.