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Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Nursing Experts

Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Choose an older adult to interview. This cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult should be 65 years or older. Use the format provided to record the responses. A list of questions is available for you to start with. Include 2–3 questions of your own to get a complete picture of the older adult. Summarize your findings and also contrast the responses with findings in your readings and other current literature Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

This form should be used as an example:
[Patient Questionnaire





Brief Introduction (Background information):

1. Philosophy on living a long life:
2. Thoughts about when a person is considered “too old”:
3. Opinion on the status and treatment of older adults:
4. Beliefs about health and illness:
5. Health promotion activities he or she participates in:
6. Something special that helped the person live so long:
7. Life span of other family members:
8. Special dietary traditions in patient’s culture attributed with aiding long life:
9. Any remedies/medications that have been handed down in family/group. If yes, describe.
10. Patient’s description of current and past health status
11. The values that guided life so far Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Additional Questions


Contrast of client’s responses with findings in current literature:]

After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of functional assessment.

Make use of the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.

Tinetti Balance and Gait Evaluation
Katz Index of Activities of Daily Living
Assessment of Home Safety
The Barthel Index

Make sure the older adult is clearly identified on the tools. Do not include their name, but do include professional or other designation, and age. Your name should also be identified on the tool. (This should be a part of your Appendix.)

Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment. During this data analysis process provide at least 4–6 preliminary issues that you have identified. Identify three alterations in health that you would propose and describe them. Identify a minimum of three comprehensive interventions for each problem. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Make sure that you integrate personal cultural awareness and cultural competency.

Paper should be 5–6 pages, not including the questionnaire or tools used. These should be attached as an Appendix. Remember to use headings to identify the different sections in your paper.

On a separate references page, cite all sources using APA format.

Patient Questionnaire

Age: 80
Questionnaire and the responses

  1. What is your philosophy on longevity of life?

“Living a long life means you led or living a good life. Those who die early have a bad life”
2. What are your thoughts about when a person is considered “too old”?

“A person is considered too old when they become less functional and start depending on others. They start getting memory problems. They start having many illnesses and have less comfortable life.”
3. What is your opinion on the status and treatment of older adults?

“Treatment of elderly people should be holistic and should start from preventive stages. Diseases of old age can be predicted and so physicians must prepare to handle them”.
4. What are your beliefs about health and illness in the elderly?

“The old get sick often and their diseases are frequently more than one.”
5. Do you participate in any health promotion activities? Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

“I help young women try to lose their weight. We have a group that meets weekly to discuss progress of weight loss over the week. I mostly play passive role though but keep the younger ones in check to achieving their target.”
6. Is there anything special that has helped you live long?

“I successfully controlled my smoking and was always watching on my diet. I also have my blood pressure under control.”
7. How many years have your other family members lived?

“My wife is 60 years old and alive. My dad died at 100 years. My mother is alive and 105 years old. My siblings are 67 and 60 years old.”
8. Is there any special dietary tradition in your culture that has contributed to your long life?

“There are nothing written by the book but we always encourage vegetarian diet. We only take meet and junk foods after the church service on Sundays.”
9. Are there any remedies that have been passed down the generation that is responsible for longevity?

“There are no medications or any other remedy that is passed down the generation tree”
10. Can you kindly describe your current and past health condition/status?

“I have high blood and that is under control. I was admitted once for very high blood pressures in the recent past. I also had Chronic Obstructive Pulmonary Disease but I stopped smoking 5 years ago and I am doing well.”
11. What are the values that have guided your life so far?
“Love for my wife and family. We always are happy and happiness lengthens our lives. We are still a strong family.” Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

12. Do you believe that the elderly are useful in the society?

“The elderly, even though dependent on people, play a crucial role in society. They have experience and have good advice for the younger ones. Even though, passively, they can play other important roles for example what I do to help people lose weight”

  1. Do you think having non-communicable diseases as you shorten life?

“I think things such as high blood pressure, diabetes take a toll on us as they are present for lifetime. They make us go to hospital many times.”
14. Why do people want to live long life?
“I do not really know. It could be because old age is associated with good life or because they want to accomplish everything they wanted to have.”

  1. Do you think that the population of elderly people will rise in future?

“Yes. I think many people are increasingly becoming old. So yes, the older people will be many in future.” Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Most of the interviewer’s views are in tandem with the literature. For example, it is true that most elderly are prone to getting illnesses. Their health deteriorates over time. Singh & Misra (2009) asset that the elderly experience many social, psychological and physical challenges in life that impact on their sense of capacity and self. They experience depression and loneliness (Singh &Misra, 2009). His view that the elderly population will rise in the near future is also true. Most of his family members are also elderly. The elderly population is growing due to advance in the level of care and health education. For example, the population of elderly has risen from 5 % in 1960 to 23% in 2010. It is also true that the elderly get many diseases. Non-communicable diseases are also on the rise. Social and psychosocial problems in the elderly hamper their ability to live a healthy life (Isaacowitz& Smith, 2003) Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person. Another research also found poor health disproportionally affects the elder although the mean-level age difference in well-being is positive or null (Arai et al., 2012).

Tinetti Balance and Gait Evaluation

Tinetti Balance and Gait score assess the chances of an elderly falling within the next one year. Each variant is given a score from 0-2 and higher scores have better outcome in terms of risk of fall.  It has a total score of 28 with values less than 19 being indicative of high risk of fall. Any value from 19 is considered to have risk of fall. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Tinetti Balance and Gait Evaluation



Balance when sitting 1
Can rise with arm support 1
He rises with single attempt 2
Standing balance is firm without support 2
Standing balance is steady with wide stance 2
Steady on nudging 2
Balance intact with eyes closed 2
Has discontinuous steps on 360 turn 0
Non-smooth motion on sitting down 1



Patient can initiate gait immediately 1
Step length and height for left and right swing foot-passes stance to the opposite 1,1
Has equal left and right step symmetry 1
Has continuous step 1
No deviation in path 2
Has no sway on trunk but slight flexion of knees 1
Heels almost touch on walking 1


(Elsawy, & Higgins, 2011)

Katz Index of Activities of Daily Living





The Katz index of independence in Activities of Daily Living was 5/6 for this patient. The points are as follows Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.


Baths without any help 1
Dresses without any help 1
Does toileting on his own 1
Can transfer himself without help 1
Has partial urinary incontinence 0
Feeds himself without help 1
INTERPRETATION Patient is independent


(Elsawy, & Higgins, 2011)

Assessment of Home Safety

The assessment of home safety for this elderly person will be considered under the living room, the status of the bathroom, bedroom and outside the house


Has doorways are appropriately wide

The living room has loose electrical cords that are unsafe

The pathways in the living room are clear

The electrical cables are not overloaded and the switch is within acceptable reach.


The bed is set low enough to be freely accessible

There is no installation of night light

There are no loose area rugs and carpet sections

There is no stable chair in the room to make dressing safer and easy

There is no rolling furniture Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person


There are no grab handles near sink, toilet or shower

The water heater temperature had not been set to less than 120 degrees

There are loose rugs on the bathroom floor

Toilet sit is raised well

No phone or waterproof medical alert device for emergency call


The sidewalk is in appropriate condition

The front door is in good condition

There is adequate lighting

There are railings along the front steps


(Tomita et al., 2014)

Interpretation: Outside the home is safe. The bathroom is unsafe. The living room is safe. The bedroom is 50% safe.

The Barthel Index assesses functional independence.

Feeding 10 Independent
Grooming 5 Independent
Toileting 10 Independent
Bowel Control 10 Has continence
Dressing 10 Independent
Transfers 15 Independent
Bladder control 5 Occasional accident
Bathing 5 Independent
Mobility on flat surface 15 Independent
Stair case movement 5 Needs help
TOTAL SCORE 95 Fully independent

Assesses for presence of dementia

0 A P
1 n N
1 A P
2 n N
2 A P
3 n N
3 A N

ITEMS RECALLED-the number of three unrelated items that the interviewee recalls

DRAWING-ability to draw clock






The patient is at the red line where he recalls only two unrelated words (dog and table) and has abnormal clock drawing and therefore tests positive for dementia

Whole Analysis-comparison

The patient tested positive for dementia. He was able to recall two unrelated words; dog and table. His clock drawing result was abnormal and therefore he tested positive for dementia on the mini-cognitive assessment. Dementia refers to progressive decline in the cognitive functions of an individual. Symptoms such as apathy, depression, agitation and other neuropsychiatric symptoms are common. With this loss of function, the patient looses independence and may require placement in home care. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person. The age-standardized prevalence of dementia from 11 European countries based on population studies was at 6.4% for all cases and 4.4 % for Alzheimer’s disease. The prevalence is higher in women than in men and nearly doubled every five-year increase in age.  For the population above 90 years, close to 30% of them had dementia. Alzheimer’s disease was present in 54% of the patients who have dementia. Thus, it is normal for the interviewee to have some form of cognitive impairment. Another important finding is the occasional loss of bladder control. This is also an expected finding in male patients of that age. Most times it can be from bladder outlet obstruction secondary to Benign Prostatic Enlargement. Other symptoms of Benign Prostatic Enlargement should be sought. The levels of the PSA will also be valuable in the further assessment of the patient. The patient should be seen by the urologist for further assessment. If enlargement is found he can be given medications or have urinary catheter in situ for symptomatic relief before prostatectomy is carried out. On physical evaluation, it was also found that, the interviewer had difficulty in climbing stairs. He has strong balance control for his age and his gait is normal for the age. Home safety found the bathroom is unsafe. To make his home safer for his age, there is need to install grab handles near the sink, toilet and the shower. The water heater also needs to be set to less than 120-degree for the maximum temperature. Further, there is need to eliminate loose throw rugs on the bathroom floor. Lastly, there is need to install a phone in the bathroom or have a waterproof medical alert device for emergency calls. The patient has Chronic Obstructive Pulmonary Disease that he has acquired due to long-standing cigarette smoking. It is commendable that he has quit smoking. However, COPD is a chronic disease and elderly patient are at risk of developing acute exacerbations. He has to be taught appropriate inhaler technique. His role in helping others lose weight is also recommendable. He plays a passive role despite being overweight. Moderate exercise is advisable for him. Apart from weight loss, it will also help him to control his blood pressures well. He is a vegetarian. DASH diet will be recommendable for him. Residential nursing care is not recommended for him as he has fairly good physical and mental functions. Further, he has a fairly young and supportive wife who can take good care of him Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.


Arai, H., Ouchi, Y., Yokode, M., Ito, H., Uematsu, H., Eto, F., … & Tsubota, K. (2012). Toward the realization of a better aged society: messages from gerontology and geriatrics. Geriatrics & gerontology international12(1), 16-22.

Elsawy, B., & Higgins, K. E. (2011). The geriatric assessment. Am Fam Physician83(1), 48-56.

Isaacowitz, D. M., & Smith, J. (2003). Positive and negative affect in very old age. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences58(3), P143-P152.

Singh, A., & Misra, N. (2009). Loneliness, depression and sociability in old age. Industrial psychiatry journal18(1), 51. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Tomita, M. R., Saharan, S., Rajendran, S., Nochajski, S. M., & Schweitzer, J. A. (2014). Psychometrics of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults. American journal of occupational therapy68(6), 711-718 Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

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