The Health History of the Aged Person

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The articles prior to January 2008 are part of the back file collection and are not available with a current paid subscription. To access the article, you may purchase it or purchase the complete back file collection here Mathy Mezey, MEd, RN; Louise M Rauckhorst, MDN, RN; Shirlee Ann Stokes, EdD, RN The purpose of this article is to discuss methods for adapting usual interviewing techniques when eliciting a history from older people. As with clients of any age, the collection of a relevant data base begins by obtaining a complete and detailed health histoiy. The history should serve as your "window" to the client. In addition to the past and present health status, it should include the client's perception of himself, detailing his/her strengths and weaknesses. The histoiy becomes the basis for assessing and interpreting the physical findings and laboratory data, and suggests appropriate nursing plans. Factors Affecting Communication - The Interviewer The young adult may have stereotypes about the elderly which will affect communication. Because of the age discrepency that often exists, the nurse practitioner may feel that the older client will be uncomfortable answering questions of a personal nature. The nurse may anticipate a response of "you have no business asking such questions. You're young enough to be my grandchild." In fact, these stereotypes are not supported by current research. The greatest desire of older people is for relationships with others. They are anxious to interact with younger people, but fear rejection. Younger adults see older clients as different from themselves. For example, calling the elderly by their first name, or by a pet name reflects a stereotype of the older adult as childlike, dependent, or senile. The older person should be addressed in terms indicating equality and respect. Another common assumption of younger adults is that the aged are dependent, and preoccupied with death. In truth, most old people live in their own home or apartments and are concerned with customaiy activities of everyday life, such as expenses, transportation, shopping, etc. The ability of the interviewer to elicit data will depend on the interviewer's comfort in asking the questions. As competency and expertise increases, the practitioner will become more comfortable in asking personal questions and forming relationships with older adults. Factors Affecting Communication - The Client Several factors may influence the completeness of the history obtained from an older person. Older people differ in their willingness to divulge their life history. If you are a stranger, he may be very suspicious since paranoia is more frequent in the older age group.1 It may take repeated contacts and careful explanations to allay fears. Under appropriate conditions, however, most older people are anxious to share their histories with a concerned and interested person. For many people over 65, the verbal tradition is not customary. A large number are foreign born and have not completed high school. A third of the urban elderly live in relative isolation, having only brief daily contacts with people, and have therefore become less verbal. For these individuals, the nurse needs to be focused in her requests for information. Older people are aware of declines that occur with aging, and are hesitant to have some of their fears confirmed. They are concerned that any illness may result in loss of independence or institutionalization. Memory loss for recent events associated with decreased ability to concentrate may exist. The older client is aware of such deficits, and may be embarrassed to discuss topics because of this. Therefore, the nurse should be as supportive and reassuring as possible throughout the interview. Older people may not understand the purpose of a complete histoiy. Many elderly have had little contact with the health care delivery system. They may fail to see the relevance to their current health of questions regarding habits, previous life experience, or social status. The nurse needs to explain the relevance of certain personal information in planning the… 10.3928/0098-9134-19770501-12

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