ADDITIONAL HISTORY FOR THE AGING ADULT
1. What changes have you noticed in your skin in the last few years?
Rationale: Assess impact of aging on self-concept. For some, normal aging changes may cause distress. Note that many changes attributed to aging are due to chronic sun damage. Aging people are greater risk of sun damage.
2. Any delay in wound healing?
* Any other skin itching
Rationale: Pruritus is very common with aging. Consider side effects of medicine or systemic disease (e.g. liver or kidney disease, cancer, lymphoma), but senile pruritus is usually due to dry skin (xerosis). Exacerbated by too-frequent bathing or use of soap. Scratching with dirty, jagged fingernails produces excoriations.
3. Any other skin pain?
Rationale: Some diseases produce more intense sensation of pain, itching in aging people, e.g., herpes zoster (shingles). Other diseases may reduce pain sensation in extremities, e.g., diabetes. Also, some aging people tolerate chronic pain as “part of growing old,” and hesitate to “complain.”
4. Any change in feet, toenails? Any bunions? Is it possible to wear shoes?
Rationale: Some aging people cannot reach down to their feet to give self-care.
5. Do you experience frequent falls?
Rationale: Multiple bruises, trauma from falls.
6. Any history of diabetes, peripheral vascular disease
Rationale: Increased risk for kin lesions in feet or ankles.
7. What do you do to care for your skin?
Rationale: The application of bland lotions is important to retain moisture in aging skin. But dermatitis may ensue from certain cosmetics, creams, ointments, and dyes applied to achieve a youthful appearance. Aging skin has a delayed inflammatory response when exposed to irritants. If the person is not alerted by warning signs (e.g. pruritus, redness), exposure may continue and dermatitis may ensue.