TEACH FOR NURSES LESSON PLAN
Chapter 32: Functional Assessment of the Older Adult
CHAPTER OBJECTIVES
1. Differentiate activities of daily living and independent activities of daily living.
2. Describe the various functional assessments that may be performed with the older adult.
STUDENT RESOURCES
understand
• Textbook Chapter 32
• Sherpath for Medical-Surgical Nursing*
• Animations (Evolve website)
• Answer Keys: Study Guide & Lab Manual
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synthesize
• SimChart*
• Simulation Learning System*
INSTRUCTOR RESOURCES
before class
• Nursing Curriculum Standards (below)
in class
• PowerPoint Presentations (Evolve)
* Sold separately from textbook.
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
FUNCTION
Activities of Daily Living
Instrumental Activities of
Daily Living
Discuss the three domains
of a functional assessment
and the two approaches.
Examine how observing a
patient’s ability to perform
tasks may be necessary
when patient-reported
• Activity: Assign students to visit an assisted living facility or a continuing care retirement community
in their area. Have them write a report on their opinion of the services offered and improvements
that could be made.
• Online Activity: Have students access several other ADL assessments, some of which are listed in the
text. Compare the assessments for thoroughness. Discuss what additional information might be
important to note.
• Activity: Have students use one of the evaluative scales on themselves, such as the Katz Index of ADL
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Assessment of Cognition
Depression and Function
Acute Care Setting
Community
Home Care
Assisted Living
Discuss the instrumental
activities of daily living
(IADLs) instruments and
their cultural and gender
Provide students with a
copy of the Tinetti Gait
and Balance Evaluation.
Using a student volunteer,
administer the test.
Discuss the significance of
the scores.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
underlying reasons for
altered cognition to
determine the appropriate
treatment.
Ask a social worker who
works with abused older
adults to address the class
on issues concerning the
mistreatment and abuse of
older adults in their
community.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
differently to stress.
Discuss the different
assessments needed,
depending on the location
of the care setting.
Discuss the assisted living
facilities and continuing
care retirement
communities available in
your area. Ask students
about their personal
knowledge of these
facilities.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
ASSESSMENT
Falls
SPECIAL CONSIDERATIONS
Assessing Those in Pain
Assessing Older Adults
with Altered Cognition
prevention services in the
health of the older adult.
Invite an exercise
instructor who specializes
in classes for older adults
who need help with
balance and strength
training to come to class
and demonstrate exercises
that can help reduce fall
risks.
using the MMSE or other tools on hospitalized older adults.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
their discouragement or
supporting health
promotion.
Explain that pain is a very
subjective feeling and that
the nurse should never
dismiss the patient’s
report of pain.
IN-CLASS/ONLINE CASE STUDY
P.J. is an 82-year–old man who presents to the outpatient office for a 6–month check-up.
Subjective Data
Lives in assisted living apartments
Widower
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Has three grown children who live nearby
Walks with cane
Complains of urinary incontinence
Objective Data
Vital signs: T 37.7 BP 108/62 HR 62 Resp 14
Questions
1. What special considerations should the nurse keep in mind regarding the physical exam for individuals in this patient’s age group?
2. What similarities does assessment of older adults have to the assessment of younger adults?
3. What are the expected findings in the older adult for the following systems: skin, hair and nails, eyes and vision, ears and hearing, mouth,
and musculoskeletal system?
5. What are some abnormal findings in the older adult for the following systems: skin, eyes and vision, ears and hearing, mouth, and
musculoskeletal system?
6. Based on the readings and the objective and subjective findings, what is the most likely cause of this patient’s urinary incontinence?
7. What interventions should be implemented for this patient’s urinary incontinence?
Answers
2. Assessment of the following systems in older adults is similar to that performed for the adult:
3. Expected findings in the older adult are as follows:
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4. Some abnormal findings in the older adult are as follows:
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NURSING CURRICULUM STANDARDS
QSEN/NLN COMPETENCIES
• Patient-Centered Care/Human Flourishing
o Function
o Social Domain
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o Assessing Older Adults with Altered Cognition
• Teamwork and Collaboration/Professional Identity
o Assessment of Risk for Functional Decline During Hospitalization
o Depression and Function
o Acute Care Setting
NURSING CONCEPTS
The following conceptual themes and specific concepts match those presented in Giddens, J. F. (2017). Concepts for nursing practice (2nd ed.).
St. Louis: Elsevier. The specific exemplars chosen and listed below for each concept have been tailored specifically to correspond to the Jarvis
textbook.
A full Concept-Based Curriculum Map covering the entire book can be found in the “Download by Resource Type” folder on Evolve.
THEME: Attributes and Resources
• Concept: Functional Ability
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o Exemplar: Assessment of Cognition
o Exemplar: Depression and Function
• Concept: Cognition
o Exemplar: Function
BSN ESSENTIALS
• Essential III: Scholarship for Evidence-Based Practice
o Activities of Daily Living
o Acute Care Setting
o Exercise
o Health Care Maintenance
• Essential IV: Information Management and Application of Patient Care Technology
o Special Considerations
• Essential VII: Clinical Prevention and Population Health
o Depression and Function
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• Essential IX: Baccalaureate Generalist Nursing Practice
o Function
ANSWERS TO QUESTIONS IN THE STUDY GUIDE
Note: Answers to these questions can be found on Evolve site. Click here.