A study on health and retirement by Rogers et al. (2015) established that older and disabled adults were at an increased risk of discrimination in healthcare settings. A 76-year-old Black/African-American male with disabilities living in an urban setting is likely to face a similar predicament. Therefore, communicative and interview techniques must adopt a sensitive approach to address the fears that such patients may harbor given their previous experiences with healthcare settings. Cuevas et al. (2016) corroborated the above observation by noting that African Americans experience higher levels of perceived discrimination, medical mistrust, and poor communication with health care providers compared to their European counterparts. Targeting of questions requires sensitivity by building a positive doctor-patient relationship. This can be achieved by creating a positive social atmosphere that caters for the needs of the disabled elderly. Moreover, using proven effective communication strategies, such as the verbal and non-verbal techniques is critical.
For the elderly and disabled African American patient, health disparities are common. The population segment is known to have an elevated risk of malignancies, diabetes, hypertension, obesity, and unintentional injury that their white counterparts. The situation is likely to worsen where disabled patients are involved. Therefore, risk assessment should be targeted towards these prevalent conditions and diseases. The questions for assessment of the risk for the chosen patient should revolve around exposure to exacerbating factors. These include financial status, home ownership, frequency of visitation to a medical doctor, history of smoking, history of obesity, physical activity, family history of genetic disorders, and general health behavior and practices including personal hygiene. At 76 years of age, the disabled patient in the case is at a higher risk of cardiovascular disease, obesity, arthritis, mental illness, and disorders related to physical inactivity.
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Comprehensive geriatric assessment (CGA) is a core and an essential part of the comprehensive care of the aging population (Jiang & Li, 2016). The framework covers critical areas including medical, physical, psychological, mental, nutritional, cognitive, social, economic, and environmental status. Some of the questions under the assessment tool would be:
What medical conditions have you been treated for in the recent past?
Does anyone in your family have a history of cardiovascular diseases?
Do you participate in any kind of physical activity or exercise?
Have you or a member of your family been diagnosed with any mental problem?
Would you say the food you eat comprises a balanced diet?
In what way would you say your current social and physical environment contributes to your overall health status?
References
Cuevas, A. G., O'Brien, K., & Saha, S. (2016). African American experiences in healthcare: “I always feel like I’m getting skipped over”. Health Psychology , 35 (9), 987.
Jiang, S., & Li, P. (2016). Current development in elderly comprehensive assessment and research methods. BioMed Research International , 2016 .
Rogers, S. E., Thrasher, A. D., Miao, Y., Boscardin, W. J., & Smith, A. K. (2015). Discrimination in healthcare settings is associated with disability in older adults: health and retirement study, 2008–2012. Journal of General Internal Medicine , 30 (10), 1413-1420.
