Health assessment of the very old person at home

Home health clinicians are adept at performing comprehensive histories and physical examinations. The very nature of home care requires that clinicians assess the whole person. In fact, the Outcomes Assessment Information Data Set (OASIS) demands a detailed evaluation of past and current medical status. As more people are living into their eighties and beyond, home health clinicians are finding themselves assessing patients who present with signs and symptoms that may be specific to very old persons. This article discusses age-related changes in the very old patient and attempts to help clinicians differentiate abnormal findings and make critical decisions regarding whether intervention is needed. This article assumes that the reader is well versed in basic health assessment and focuses on specifics related to the assessment of the very old patient living at home.