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Physical assessments: Adapt to elderly residents with these eight environmental modifications

LTC Nursing Assistant Trainer, January 15, 2009

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Physical assessment of elderly individuals can present many challenges. Over time, you will become proficient in adapting the environment and modifying the examination to account for sensory changes, slower response time, acute or chronic diseases, and the resident’s need for assistance. Avoid stereotyping the resident or making assumptions about his or her mental status or physical abilities. Individualize the examination to accommodate the resident’s deficits. Anticipate the process may take longer than it would with a younger resident. If a caregiver or family member is present, privately ask the resident to state his or her wishes regarding whether this person should be asked to leave the room during the examination.

Consider the following environmental modifications when examining a resident:

• Elderly people are often very modest and uncomfortable if clothing is removed; arrange for a warm, private area
• Provide draping for comfort and warmth
• Position the resident in a comfortable position that he or she can maintain during the exam
• Provide pillows, props, or other positioning aids as needed
• Provide bright nonglare lighting
• Eliminate background noise
• Warm instruments before touching resident
• Provide a chair with arms and a high seat

This is an excerpt from HCPro’s book, Resident Assessment and Monitoring for Long-Term Care: Essential Tools and Guidelines for Clinicians, written by Barbara Acello, RN, MSN.

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