Evaluating older adult self-care capacityNursing made Incredibly Easy: March/April 2019 - Volume 17 - Issue 2 - p 1 doi: 10.1097/01.NME.0000553649.55595.be CE Connection Article MetricsMetrics GENERAL PURPOSE: To examine the role of nurses in assessing the self-care capacity of older adult patients. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Identify the elements of a safety and self-care assessment for older adults. 2. Enlist tools and resources to evaluate self-care capacity in older adults. The terms capacity and competency are interchangeably used to describe mental status. both legal terms referring to autonomy. examples of a clinical and legal term, respectively. Which ethical principle sometimes conflicts with the realities of low capacity? do no harm autonomy justice A functional assessment for an older adult includes a cognitive evaluation. an evaluation of the individual's social network. an evaluation of personal financial management. A comprehensive capacity assessment of an older adult is best executed by a social worker. an interprofessional team. a long-term care admissions coordinator. An older adult patient tells you he stopped taking his antihypertensive medication because he thinks it makes him dizzy. According to the four elements of decision-making capacity, your patient is demonstrating understanding. choice. nonadherence. An independent-living older adult patient is showing signs of cognitive impairment but refuses a medical evaluation. Referral to Adult Protective Services is indicated. should be done by the family. puts you at risk for legal liability. Which isn't a red flag that your older adult patient may have cognitive impairment? weight loss frequent hospital admissions not taking medications because of cost Older adults with confusion and memory loss should be evaluated for possible dementia and delirium. psychosis. attention-seeking. Suspect delirium in an older adult if cognitive changes have been present for several months. have an abrupt onset. are related to a psychiatric history. A condition in older adults that can mimic dementia is urinary tract infection. hearing loss. depression. What data can nurses contribute to a dementia assessment? assessment of the patient's capability in performing ADLs completion of a comprehensive mental status exam evaluation of the patient's family dynamics An important consideration when taking an older adult's health history is to dispense with a history of childhood conditions. allow sufficient time for the patient to answer questions. talk more loudly. When completing a functional assessment, an example of a needed activity for independent/safe living is using the phone. toileting. bathing. An indication of potential poor nutritional intake is an unintentional weight loss of greater than 5% in 6 months. greater than 10% in 6 months. 10% or greater in 1 year. Having a patient draw a clock as part of a mental status exam assesses attention and retention. the degree of cognitive decline. visuospatial and executive function. A drawback of using the MMSE as a cognitive screen is it doesn't assess memory. the cost of the tool. the long administration time for 50 questions. An advantage of using the Mini-Cog exam includes that it is diagnostic for Alzheimer disease. assesses for attention and conceptualization. takes 5 minutes or less to complete. When testing older adults for capacity, it involves a legal determination. it's important to use diagnostic tools. no one test or tool is sufficient to make a determination. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.