Resources for Improving Care to Older Adults: Assessing the Whole Human

This list of resources was compiled under an MDHHS grant for services to older adults. These tools can be used for anyone by anyone to ensure approaches consider the changing needs.  Research has shown that in assessing and planning with a person as they move through the aging process, there are 5 elements that should be addressed:

Sleep                    Nutrition

Pain                      Exercise                    Community/social connection

As we are in the age of integrated care, and since we know that all things that are going on with a person influence their whole life experience, we cannot rely on others to ensure these things are being addressed. Eliciting discussion of these points not only conveys interest and concern, but information gained is crucial to pass on to prescribers as these may affect medication regimens.

Sleep – of course we think about this in assessment of symptoms related to mood disorders however, it is relevant for everyone.  It is a fallacy that older people need less sleep; they get less sleep due to many factors but in fact they need as much as anyone, 7-8 hours per night. Lack of sleep affects everyone’s mood, we know this from our own experience. If prolonged, lack of sleep increases confusion, irritability and motivation. Getting an accurate picture of how many hours of sleep a person gets is difficult; many of us think we lay awake all night, but in truth it may just feel that way. Either way, it is important to have the discussion and convey your findings. See attached Sleep Diary and following resource.

Pain – not everyone who complains of pain is seeking pills, and not everyone experiencing pain can or will express it. But think what it is like when you have a sore shoulder…imagine someone trying to help you dress and every time you raise your arm, it hurts. If you can’t express that, you might try to avoid the activity in a variety of ways, all of which could be read as ‘non-compliant’. This can lead to a myriad of avoidable situations if it can be established that there is pain that could be relieved with Tylenol. See Faces Pain Scale and Using The Pain Scale.

Nutrition – appetite, tastes and access to healthy food all may change with age. Of course, it can also be impacted by mood.  Lack of good nutrition not only affects the aging process but it can also affect how medications are metabolized. Often people have limited choice in their meals unless they are on a prescribed diet. They may get cheap, easy and often caloric foods when cleaner, healthful options are not sought. Reminders of healthy and tasty substitutions can be helpful to the person and/or caregiver. See attached Nutritional Needs and My Healthy Plate.

Exercise – Sounds like great fun…we do it because we know it’s good for us and that remains true throughout life. To address the most common physical conditions plaguing older, inactive adults (heart disease, diabetes, …) a little exercise can be a big deal. Try a walk during a visit – 5 minutes to the corner. Try sitting stretches – most people can do that (and it will energize you too).