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  1. Walker, Jean T. RN, MSN, PhD
  2. Lofton, Susan P. RNC, CNS, PhD
  3. Haynie, Lisa RN, FNP, PhD
  4. Martin, Tina RN, FNP, PhD


The number of old and very old patients that we encounter is significantly on the rise. Never has the need been so great for nurses to view their older patient population base as a true specialty. With the responsibility of caring for our older patients comes the need and responsibility to know and use correct assessment parameters for this unique group. A geriatric assessment is a comprehensive evaluation designed to explore and gain information about the older person's functional abilities or limitations in order to help improve overall quality of life and enable him or her to live independently for as long as possible. Such a comprehensive assessment includes physical, psychological, and social dimensions.


As with other adult life cycles, the geriatric population is not immune to mental health disorders such as depression or anxiety. Assessment and diagnosis of late-life mental disorders are especially challenging for today's home health nurse. The symptoms presented by older adults may be different from those found more commonly in younger patients, making the disorder more difficult to determine. Additionally, many older patients are reluctant to report symptoms, afraid of the social ramifications and the stigmas attached to an aging mind. The elderly are more likely to seek medical attention for physical symptoms than for feeling depressed. Comorbidity with other medical disorders, and even the effects of normal aging, may result in misdiagnosis and inappropriate plans of care. This article is intended to explore three distinctive disorders in the elderly that often mimic each other, sharing some basic symptoms, and to assist the home healthcare nurse to differentiate between the three: dementia, depression, and delirium.