A white male patient came for a consultation because of the health-associated changes he has been observing for a year already. This 78-year-old man lost 10lb and became much weaker than he used to be. The patient has not tried to change this condition intentionally, and he cannot explain why his physical state worsened. Over the past 6 months, he has become less active and exhausted. Nevertheless, his symptoms cannot be associated with any side-effects of medications because he uses only a multivitamin.
Unintended weight loss is a critical issue that is severe enough to contact a healthcare provider for a patient of any age. Those individuals who are older than 75 years old should pay even more attention to this problem, especially when it is associated with exhaustion. Healthcare professionals indicate that the elderly can experience these symptoms if they suffer from various conditions (Lipschitz, 2016). To specify what exactly is wrong and to improve a patient’s health, nurses should ask a range of questions to ensure that proper assessment is managed. Taking into consideration the fact that the patient lives alone and his relatives are not present, he will be the one to answer them. As the effects of drugs are excluded, the following questions should be asked:
- Have you felt lonely and hopeless recently? (The patient may suffer from depression).
- Have you had any thoughts associated with suicide?
- Do you have any problems with sleep?
- Can you associate your decline in energy with your mood?
- How often do you communicate with other people?
- Do you have any relatives who suffered from cancer? (Patient’s symptoms can be associated with cancer).
- Have you had any pains recently? (Polymyalgia rheumatic is possible).
- Have you suffered from coughing? (The patient may have tuberculosis).
- Have you had a fever recently?
- Do you have problems with memory? (The earliest stages of Alzheimer’s disease have such symptoms).
- Have you experienced confusion about time and place?
- What is your diet? (Malnutrition is possible).
Unfortunately, patients’ answers are not enough to find out what is wrong with them. Additional screening can improve this situation significantly (Gaddey & Holder, 2014). For instance, blood tests can reveal the presence of inflammation that is associated with polymyalgia rheumatic, and malnutrition. MRI provides an opportunity to diagnose polymyalgia rheumatic and cancer. Biopsy and a Pap test can also be used for cancer. Genetic testing and a mini-mental state exam can be appropriate for Alzheimer’s disease as well as a neurological exam. Mental status testing is needed for Alzheimer’s disease and depression.
Taking into consideration the fact that the patient is almost 80 years old, it is vital to consider his frailty. This syndrome is common for the elderly in particular. Its symptoms are similar to those experienced by the patient (Chen, Mao, & Leng, 2014). To define if it is the reason for his condition, nurses should reveal whether the patient suffers from one or several previously discussed diseases.
Referrals to a psychologist may be needed, as the patient can suffer from depression. A nutritionist can help a patient to improve his diet and ensure that it gives him enough energy. Geriatric professionals should be approached especially if the patient is willing to return home because he is likely to require additional care. A nurse can visit him at home and ensure that he experiences no issues.
Chen, X., Mao, G., & Leng, S. (2014). Frailty syndrome: An overview. Clinical Interventions in Aging, 9, 433-441.
Gaddey, H., & Holder, K. (2014). Unintentional weight loss in older adults. American Family Physician, 89(9), 718-722.
Lipschitz, D. (2016). Unexplained weight loss a bad sign for older people. Web.