Question

B. E. is a 68-year-old man who presents to the outpatient office with continuing visual pain and joint pain in his left knee. As you begin taking his history, you notice he is wearing a hearing aid. You decide to do a functional assessment.

He states that he can bathe himself as long as he sits down to bathe but cannot climb into the bathtub. His wife has placed a chair in the bathroom for him to use during bathing. He has not difficulty with toileting, dressing, or eating but “gets tired and sore” if he walks more than a block. He dreads going to stores because he can’t “walk that much” and relies on his wife for grocery shopping, housekeeping, cooking, and doing the laundry. He hires a neighborhood boy to mow the lawn. He is able to drive without difficulty; his car has automatic transmission. He lives in a two-story house and says that once he is downstairs for the day, he tries not to go upstairs until bedtime. His home has one bathroom on the lower level. He is a retired postal worker and enjoys spending time with his wife in the flower garden. Lately the knee pain has kept him from doing his gardening chores. He is active in his church and local civic clubs. He and his wife have been looking forward to a seniors’ cruise that is scheduled in 2 months.

1)     What are three additional questions you might ask regarding his history?

2)     What is your assessment of B. E.’s self-care ability? Are there other questions that may be included in a functional assessment?

3)     What can you do to enhance your communication with B. E. during the interview and examination?

4)     When assessing his hearing, B. E. states he has worn his hearing aids for 2 years. He says that in the last few months it seems to be less effective although he replaced the battery. What could be causing this hearing loss?

5)     On the basis of the above assessment, what are expected findings in the aging person?

Answer 1

Answer 1. The questions to be asked to B. E regarding his history can be like, does he have any other chronic ailment? Do any of his close family member has some or the other health issues? Did he face any accident or mishap in previous years which could possibly lead to knee issues or hearing impairment ?

Answer 2. In respect of self care, B. E is taking good care of himself as he can do many daily basic works on his own. But he is dependent on others also, as he can't walk much. So regarding this, some more queries arise like, is there any medicines he is already taking for pain? Is he following any pattern of pains or is it continuous? How often he feels pain in his eyes? And from how much time he feels that his hearing aids are not working or his hearing defect has increased?

Answer 3. To enhance communication, more methods of interactions need to be included like physical tests, recommendations of hearing tests, asking more about his illness and its history, questioning about his diet routines, and asking about his previous medical reports.

Answer 4. B. E's hearing loss could the possible result of age factor, as with time or age the hearing ability of majority people decreases and somehow continue decreasing. Other possible reason can be blockage by wax in ear, which causes issues with hearing aid malfunctioning. Also, the possible reason could be corrosion in the hearing aid due to humidity or moisture inside it.