Building a Health History

To evaluate a health risk assessment of patients, it is vital to obtain a concise health history. Effective communication with patients is crucial to build a health history and provide treatment. According to Ball, Dains, Flynn, Solomon & Stewart (2015), effective communication helps to establish a positive relationship with the patient. Moreover effective communication is built on courtesy, comfort, connection and confirmation.Therefore, the advance practice nurse must consider how best conduct an interview of patients that is individualized, and based on patient factors such as age, gender, ethnicity and environment.
Interview and Communication Technique
A 76-year-old African-American male with disabilities living in an urban setting will be used when discussing the interview and communication technique. Setting is an important aspect of the interview process. Ensuring the comfortability will aid in communication. Providing an open atmosphere, such as removing large desks from obstructing the patient from the provider can provide comfort. Sitting close to the patient will enure the older adult can effectively hear and understand the questions (Ball et. al., 2015). Another technique is to introduce oneself to the patient. Making one’s role clear and providing the objective of the interview. Addressing the patient formally provides respect and dignity, no matter their age but especially in the older adult. Moreover, while it is important to write the health history, it is equally important to keep eye contact, and nodding head to ensure respect and undivided attention (Ball et. al., 2015). When asking sensitive questions such as sexual activity, alcohol, drug use, or sexual transmitted diseases, one should provide privacy, but should still be direct and firm. Although, these questions may be uncomfortable, they are an important part of the health history process and treatment (Ball et. al., 2015). Lastly, for the elderly, or disabled patients, the advanced nurse should understand their limitations. Involving primary care taker to help with the health history is vital. Adapting questions to fit the individual’s need is also an effective technique. For example, utilizing an sign language interpreter for a deaf person. Using simple and short sentences for an elderly fragile patient with physical and cognitive limitations is also helpful (Ball et. al., 2015). 
Risk Assessment
According to Wu & Orlando (2015), a “health risk assessments provide an opportunity to emphasise health promotion and disease prevention for individuals and populations at large” (para. 1). In the older adult, declining in cognitive and physical ability, multiple chronic and progressive diseases place them at great risk for life threatening events (Ball et. al., 2015). Therefore, it is important to include a functional risk assessment on the elderly and disabled patients to ensure their safety. A functional assessment “attempt to understand a patient’s ability to achieve the basic activities of daily living. This assessment should be made for all older adults and for any person limited by disease or disability, acute or chronic” (Ball et. al, 2015, p. 19).
Functional Assessment Questions
Asking targeted questions related to functionality will provide the advanced practicing nurse on how well the patient can care for himself. According to the National Prevention, Health Promotion and Public Health Council (2016), in 2014, 46 million adults were age 65 years or older. It is predicted by 2030, this number is expected to reach 74 million. Thus, future advanced nurse practitioners will encounter an increased number of older adults with many health concerns. Therefore, assessing these individuals for daily functionality level will help in the treatment plan.
The following are questions that will be asked to assess functionality related to activities of daily living for a 76-year-old African-American male with disabilities living in an urban setting. 1) Do you have difficulty walking around? 2) Do you have difficulty walking up and down stairs? 3) Do you have difficulty taking a bath? 4) Do you have difficulty getting dressed? 4) Do you have difficulty holding objects, such as opening a your medicine bottle? 5) Do you buy your own groceries? 6) Do you prepare your own meals? 7) Are you able to clean your house?