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Abstract
A comprehensive assessment is the first stage of the nursing process. In rehabilitation nursing, it provides the foundation for care that enables individuals to gain greater control over their lives and enhance their health status. The place of the older person and significant carers/family members in assessment cannot be overestimated, as each should be empowered to fulfill the role of imparting expert knowledge about the person's life experience and views. This article examines some pertinent issues in relation to nursing assessment and emphasises that identification of needs and the use of appropriate assessment tools, in conjunction with the knowledge, skills and clinical judgement of the practitioner, are required in assessment.
Key words
* Patient assessment
* Rehabilitation
* Elderly: screening
These key words are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.
The National Service Framework for Older People (Department of Health (DH) 2001) stipulates that older people have a right to resources based on clinical need. Holistic assessment is the foundation of all individualised and person-centred nursing care. Such assessment provides information that is critical for appropriate referral, whereby health and social care professionals, in partnership with the individual, can initiate and develop a plan of action and therapy that enhances health status (Table 1).
For the purpose of this article, nursing assessment will focus on four key areas:
* acute confusion
* nutrition
* medication self-management
* impaired mobility.
These areas were chosen as they are common areas of concern in a growing older population, and difficulties in relation to any one of them will often impact negatively on the others. Nursing models, such as the Activities of Daily Living Model (Roper et at 2000) and the Self Care Theory (Orem 2001), can be used as a framework to guide nursing care, but it is the person and his or her particular circumstances and needs that must dictate the approach adopted. A holistic nursing assessment is completed when the nurse's knowledge, skills and experience are used in listening, observing, measuring, interpreting and recording information about the older person's biological, psychological, social and spiritual needs (Royal College of Nursing 2004). Standardised assessment tools are used in conjunction with clinical judgment and, where...