Because of the complexity of the older patient and the vagueness of his or her complaint, you should:

• A. attempt to differentiate between chronic and acute problems.
• B. rely exclusively on family members for the medical history.
• C. limit your physical examination to the area of pain or injury.
• D. perform a rapid assessment on all geriatric patients you treat.

Answer: (A)

Older adults often live with multiple chronic conditions, and their symptoms can be vague or nonspecific. The best approach is to figure out what is new or acute while considering what is already present as a chronic baseline. This helps you identify an urgent issue that needs immediate management and avoids missing a serious problem hidden by a chronic condition or by atypical presentation.

By differentiating acute from chronic, you gather a fuller history and perform a broader exam that looks beyond the site of discomfort, checks for changes in function, cognition, medications, and other systems, and guides appropriate testing and treatment. It also helps you avoid over-reliance on family members for information alone, which might omit important details, and it prevents restricting your assessment to the painful area, which could overlook other contributing problems. A rapid, one-size-fits-all assessment for every geriatric patient isn’t a substitute for this broader evaluative approach, since older patients can present with subtle or nonlocal signs of serious illness.