Chapter 3: Functional Assessment of the Older Adult, 2nd Edition 4 CCUs
By: Veronica Southard, PT, DHSc, GCS, CEEAA Learning objectives
Based on the ICF model, describe age-related changes in personal and environmental factors, along with appropriate assessment tools. Identify additional factors that may affect the functional assessment of older adults.
After completing this course, the learner will be able to: Identify current demographics and health trends among adults age 65 and older. Define health and function of older adults using the ICF model and Schwartz’s “slippery slope” continuum. Based on the ICF model, describe age-related changes in body structure and function, activity, and participation, along with appropriate assessment tools. Course overview Adults age 65 and older represent the fastest growing population both in the United States and in the world (Administration on Aging [AoA], 2013, 2017). Older adults represent a challenging and unique population due to the broad variability and range in age, abilities, and overall health. Physical therapy practitioners and other rehabilitation providers play a pivotal role in maximizing function, participation, and well-being for older adults. To be effective in this role, however, rehabilitation professionals must have a strong understanding of the complex interplay among typical age-related changes, chronic conditions, and the environment. Most importantly, the physical therapist must be able to use the most appropriate assessment tools to address these factors. Implicit bias in healthcare Implicit bias significantly affects how healthcare professionals perceive and make treatment decisions, ultimately resulting in disparities in health outcomes. These biases, often unconscious and unintentional, can shape behavior and produce differences in medical care along various lines, including race, ethnicity, gender identity, sexual orientation, age, and socioeconomic status. Healthcare disparities stemming from implicit bias can manifest in several ways. For example, a healthcare provider might unconsciously give less attention to a patient or make assumptions about their medical needs based on race, gender, or age. The unconscious assumptions can lead to delayed or inadequate care, misdiagnoses, or inappropriate treatments, all of which can adversely impact health outcomes. Addressing
This intermediate-level course reviews key age-related changes and common health issues that challenge functional performance and participation among older adults. Evidence- based guidelines and tools to assess the multidimensional health needs of older adults using the ICF model are presented, with special considerations for gerontologic and culturally sensitive practice. This course will enable physical therapy practitioners to understand and assess functional performance in older adults using a multidimensional approach. Client factors (including physical, cognitive, and psychosocial factors) and their impact on performance skills will be reviewed. The ICF model will serve as the basis for assessment and determination of functional limitations and contextual factors. Various measurement tools are provided as possible resources for clinicians. implicit bias in healthcare is crucial for achieving equity in medical treatment. Strategies to combat these biases involve education and awareness programs for healthcare professionals. These programs help individuals recognize and acknowledge their biases, fostering a more empathetic and unbiased approach to patient care. Additionally, implementing policies and procedures prioritizing equitable treatment for all patients can play a pivotal role in reducing healthcare disparities. Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system where everyone receives fair and equal treatment regardless of their background or characteristics.
INTRODUCTION
From 2008 to 2016, 35% of adults age 65 or older in the United States reported having some type of disability (AoA, 2017); two-thirds of this group of older people reported having difficulty walking or climbing stairs (He & Larsen, 2014). Given these statistics, a new paradigm is necessary for examining health and wellness in older adults. Groups such as the World Health Organization (WHO; 2010) and the American Physical Therapy Association (APTA; 2015) promote the adoption of multidimensional measures, such as those that examine performance, satisfaction, and participation in daily activities, as constructs defining health and disability.
The United States is experiencing a rapid growth among its oldest residents. Most recent reports from the Administration on Aging (AoA; 2017) note that, as of 2016, there were 49.2 million adults age 65 and older, and this number is projected to increase to 98.2 million by 2060 (Figure 1). By 2040, one out of every seven Americans will be over the age of 65. The greatest increase among older adults is occurring among those age 85 and older; this group currently represents approximately 21% of all older persons (AoA, 2013). Aging can be associated with many health challenges that compromise the ability to live independently and participate in life. The longer people live, the more at risk they are for experiencing chronic health conditions and limitations in functional abilities resulting in the need for assistance from others (Figure 2).
Page 37
EliteLearning.com/Physical-Therapy
Powered by FlippingBook