One of the major differences is determining frailty in older adults.  Frailty was defined by Laukli et al., (2021) as an identifiable decline in physiological systems that appear later in life.  This is where that old adage age is just a number as some older adults will develop frailty sooner than others.  But the aging process definitely takes a toll on the body physiologically with decreased mineralization resulting in weak bones, malabsorption issues due to decreased motility that can lead to vitamin deficiency, weaker skin due to the loss of elastin and collagen that predispose them to tear, and decreased adipose tissue which leads to less insulation and increased water loss (Bickley, 2017).  Assessing frailty using the criteria of Frieds Frailty Phenotype (FFP) weight loss, exhaustion, physical activity, usual gait speed, and grip strength can help determine increased risks associated with adverse outcomes like falls, delirium, and skin issues such as pressure ulcerations (Laukli et al., 2021). This is important because if a young 35-year-old female falls from a standing position she is less likely to break a bone and sustain a serious injury than a 100-year-old female who falls from the same height.  Due to the physiological changes, we all go through an older citizens may need additional help with cleaning, home maintenance, and maybe due to their age and limitations they may no longer feel safe at home.  These are the questions we need answers to when assessing older adults, without making them fearful of us putting them in a nursing home.  At some point, we need to help them realize that they will have limitations in their life which may include care as in a nursing home due to our current inability to make them young and healthy again.  Safety should always be the top priority but also include such choices as home care and home hospice care for as long as it is available and safe.  I would not be assessing a 35-year-old for falls in the home but I would assess a 75-year-old for this.  I would also be screening a 35-year-old for breast cancer and not a 95-year-old (Bickley, 2017). Also with the older adult, I can likely rule out disease conditions that would have been caught at a younger age such as Crohns disease, most cancers, celiac, and Lupus to name a few.  Screening younger adults, I would defiantly need to check on many of these conditions if the patient was symptomatic to rule them out.   But the older adult has probably outlived the negative outcomes of these conditions especially if they are not genetically predisposed to them. 

Reference

Binkley, L. (2017). Bates guide to physical examination and history-taking (12^th ed.). Wolters Kluwer. 

Laukli, I., Sandvik, L., & Ormstad, H. (2021). Frailty assessment of older adults, first-time applicants of public home care service in Norway. Scandinavian Journal of Primary Health Care, 39(1), 39. https://doi-org.aspenuniversity.idm.oclc.org/10.1080/02813432.2021.1880069

Course Objective:

N495: Health Assessment

Health Assessment focuses on the complete health assessment, the nursing process, and its relationship to the prevention and early detection of disease in diverse patients across the life span. The process of health assessment is introduced, including: interviewing, history-taking, and physical assessment. Health assessment occurs within the context of the family and community and incorporates cultural and developmental variations and needs of the patient. Normal findings and cultural and age variations are emphasized. Incorporated throughout the course is the importance of communication and collaboration with patients and health care professionals. This course prepares the professional nurse to apply the concepts, knowledge and skills necessary to complete a health assessment for patients in all age groups, emphasizing the major elements, sequence and methodology of health assessment. This course also serves as a foundation for a graduate-level health assessment course.

Course Learning Objectives (CLO):

By the conclusion of this course, student will be able to:

1. Demonstrate skill in systematic data collection methods: Interviewing, observation, physical examination, and mental health assessment
2. Apply anatomical, physiological, psychosocial, nutritional, developmental norms and theories, cultural and environmental factors to interpret health assessment data
3. Differentiate normal findings for the clients age, developmental stage, and cultural background and those unusual or abnormal findings, which need further evaluation
4. Identify information technology sources to generate assessment data
5. Communicate health assessments effectively in both oral and written form
6. Discuss common pathophysiological mechanisms in relation to health assessment, health promotion and disease prevention
7. Identify age-appropriate patient teaching and health promotion activities

Course Materials:

Required Textbook:

• For a list of required textbooks and resources, please see your program and course list here: https://www.aspen.edu/bachelors-degrees/
• Shadow Health

Professional Standards

• AACN Essentials of Baccalaureate Nursing
• AACN Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice
• AACN Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety
• AACN Essential IV: Information Management and Application of Patient Care Technology
• AACN Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes
• AACN Essential VII: Clinical Prevention and Population Health
• AACN Essential VIII: Professionalism and Professional Values
• AACN Essential IX: Baccalaureate Generalist Nursing Practice

Course Structure:

Module 1: Normative Aging Changes

Module 2: Preventative Screening and Vaccines

Module 3: Healthy Aging and Ego Integrity

Module 4: Exercise

Module 5: Stress

Module 6: Emergency Plan for the Older Adult

Module 7: Holistic Assessment of the Older Adult

Module 8: Comprehensive Assessment