Acute symptom assessment: determining the seriousness of the presentation.

Nursing home residents are typically frail elders of advanced age who have comorbidities and are taking multiple medications. These residents are particularly vulnerable to acute illness and often demonstrate this illness in an atypical fashion. Nursing home staff need to be skilled in the recognition of acute illness and exacerbations of chronic illness in the resident so that expeditious assessment and management of disease or illness is ensured. The clinician with advanced skill in symptom and sign assessment and management strategies is better prepared to make an accurate diagnosis and to teach the nursing staff the critically needed observation and assessment skills.