MODULE 8 FUNCTIONAL ASSESSMENT FOR OLDER ADULTS
Activity 8-1:
Describe your client’s health history:
a. Current health
- Does he/she has chronic problems such as diabetes, high blood pressure, arthritis or
heart disease? He has arthritis
- Does he/she has pain, unusual sensations or lack of sensation? sometimes
- Doe he/she have cough, shortness of breath, or other trouble breathing? none
- Does he/she have headaches, dizziness, weakness, fainting spells, or excessive
sweating? He sometimes experiences dizziness
- Does he/she have swelling, discharges from anywhere? No
- What are the medications taken, prescription, OTC , or home remedies?
Serpentina capsule, Vitamin D3, glucosamine.
b. Past health
- Does he/she was immunized (given shots or vaccinated) for any disease?
- What are the childhood diseases he/she had? Ex: measles, chickenpox
- What surgeries he/she had? none
- Was he/she treated with mental problems such as depression? No
- Was he/she hospitalized for any reason? No
- Does he/she has drugs / food allergies? None
c. General health habits
- Diet: does he/she has a special diet? What food he/she normally eat? He eats vegetables.
- Eating problem: Trouble swallowing? Nausea or vomiting after eating. NONE
- Intake of water /day: does he/she drinks coffee, tea or carbonated drinks? He drinks coffee
- How many hours of sleep? Take naps? Sleeping problems? 8 hours
- Bowel habits: does he/she use laxatives, suppositories, enemas? Diarrhea or
constipation? So far, None
- Bladder habits: how many times/day? How much he/she urinates? Problems in
urinating? NA
- Type of exercise? How often? NA
- Does he/she drink alcoholic beverages? What kind? How often? NO
- Does he/she smoke? If so, what and how often? NO
- Does he/she wear glasses? Hearing aids? dentures? Describe if there is hearing or
vision loss. Yes he wears eyeglasses, has difficulty in hearing
- Does he/she use a cane? Crutches? Or walker? No, he can still manage to walk all
by himself
Activity 8-2: Katz Index of Independence in Activities of Daily Living
Independence means without supervision, direction, or active personal assistance, except as
specifically noted below.
Activities Independence Dependence
Points (1 0r 0 ) (1 Point) (0 Points)
NO supervision, direction or personal WITH supervision,
assistance direction,
personal assistance or
total care.
BATHING (1 POINT) Bathes self completely or 0 POINTS) Need help with
Points: ___1____ needs help in bathing only a single part of bathing more than one
the body such as the back, genital area or part of the
disabled extremity. body, getting in or out of
the tub or
shower. Requires total
bathing
DRESSING (1 POINT) Get clothes from closets (0 POINTS) Needs help
Points: ____1____ and drawers and puts on clothes and with
outer garments complete with fasteners.
May have help tying shoes. dressing self or needs to
be
completely dressed
TOILETING (1 POINT) Goes to toilet, gets on and (0 POINTS) Needs help
Points: ___1____ off, arranges clothes, cleans genital area transferring to the toilet,
without help. cleaning
self or uses bedpan or
commode
TRANSFERRING (1 POINT) Moves in and out of bed or (0 POINTS) Needs help in
Points: ____1_____ chair unassisted. Mechanical transfer moving
aids are acceptable from bed to chair or
requires a
complete transfer.
CONTINENCE (1 POINT) Exercises complete self (0 POINTS) Is partially or
Points: ____1______ control over urination and defecation. totally
incontinent of bowel or
bladder
FEEDING (1 POINT) Gets food from plate into (0 POINTS) Needs partial
Points: ____1______ mouth without help. Preparation of food or total
may be done by another person. help with feeding or
requires
parenteral feeding.
TOTAL POINTS: _____6___ SCORING: 6 = High (patient independent) 0 = Low (patient very
dependent
Source:
try this: Best Practices in Nursing Care to Older Adults, The Hartford Institute for Geriatric
Nursing, New York University, College of
Activity 8-3:
The Mini-Mental State Examination evaluates orientation, registration, attention and calculation,
recall and language. The maximum score is 30. Scores are evaluated in the following manner:
24-30: no cognitive impairment
18-23: mild cognitive impairment
0-17: severe cognitive impairment
Norberto R. Avancena Dec 2 2021
17
4. Social Health
Assessment of social functioning reveals how well the individual is functioning within the
environment. Social aspects assessed include the various social groups (eg. Church groups,
clubs, neighbors, volunteer agencies) that the individual belongs to and the support that is
received form these groups. Areas of importance include frequency and number of social
contacts, amount of support offered (ie, emotional and financial). All support groups do not
provide
the same amount of kind of support. Adequate social support helps the elderly person face
stressors, provides emotional support, and offers an avenue for enjoyment and activity.
When doing a social functioning assessment, question the elderly person about the number of
social contacts within the past week, the type of support from those contacts, who they could call
on for help if needed, and how often they visit their family. Social relationships should be fairly
satisfying, and the elderly should be able to identify at least one person who would care for them
indefinitely.
Activity 8-4: Social Dysfunction Rating Scale
Social Dysfunction Rating Scale, is a 21-item scale with each item receiving a score from 1-6
points, depending on the amount of dysfunction observed. It is helpful in identifying individual
dealing with personal, interpersonal, and geographic environments in a maladaptive manners.
The scale is useful in assessing the need for treatment change or as a measure of social
dysfunction.
Directions: Score each of the item as follows:
1. Not present
2. Very mild
3. Mild
4. Moderate
5. Severe
6. Very severe
SELF-ESTEEM
1. _mild___ Low self-concept (feelings of inadequacy, not measuring up to self-ideal)
2. _Very mild___ Goallessness (lack of inner motivation and sense of future orientation)
3. __not present__ Lack of satisfying philosophy or meaning of life (a conceptual framework for
integrating past and present experiences)
4. _Mild___ Self-health concern (preoccupation with physical health, somatic concerns.
INTERPERSONAL SYSTEM
5. _not present___ Emotional withdrawal (degree of deficiency in relating to others)
6. _not present___ Hostility ( degree of aggression towards others)
7. _not present___ Manipulation (exploiting of environment, controlling at other’s expense)
8. _not present___ Over dependency (degree of parasitic attachment to others)
9. _not present___ Anxiety ( degree of feeling of uneasiness, impending doom)
10. __not present__Suspiciousness (degree of distrust or paranoid ideation.
PERFORMANCE SYSTEM
11. _Mild___ Lack of satisfying relationships with significant persons (spouse, children, kin, significant
persons serving in a family role.
12. _Mild___ Lack of friends, social contacts
13. _Not present___ Expressed need for more friends, social contacts
14. _Mild___ Lack of work (remunerative or nonremunerative, productive work activities) that normally
give a sense of usefulness, status, confidence
15. _Very mild___ Lack of satisfaction from work
16. _Mild___ Lack of leisure time activities
17. _Not present___ Expressed need for more leisure, self-enhancing and satisfying activities
18. _Mild___ Lack of participation in community activities
19. _Mild___ Lack of interest in community affairs and activities that influence others
20. _Not present___ Financial insecurity
21. _Mild___ Adaptive rigidity (lack of complex coping patterns to stress)
Summary
Functional assessment measures the physical. Functional, psychological, as well as social
aspects of health and well-being of the older adult. Aging effects and chronic illness crate wide
variations in the functional status of older adults. It is therefore important to develop knowledge
and skills for accurate assessment.
