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Obtaining the Medical History
When patients are older, obtaining a good history—including information on social circumstances and lifestyle as well as medical and family history—is crucial to sound health care.
“What brings you here today?”
Mr. Symonds has advanced lung disease and usually manages well with home oxygen. But, he’s been admitted to the emergency room three times in as many weeks, unable to breathe. The health team is puzzled because Mr. Symonds is taking his medications on schedule and, he says, using the oxygen. Finally, a home care nurse is sent to the Symonds’ house. She discovers that because of this winter’s bitter cold, Mr. Symonds has been running a kerosene heater in his kitchen. He does not use the oxygen and heater at the same time for fear of fi re.
The varied needs of older patients may require different interviewing techniques. The following guidelines can help you to obtain a thorough history of current and past concerns, family history, medications, and socioeconomic situation. These suggestions are less time-consuming than they may appear.
Some involve a single investment of time. Other health care professionals in the offi ce or home may assist in gathering the information. You may want to get a detailed life and medical history as an ongoing part of older patients’
offi ce visits and use each visit to add to and update information.
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