Patients who are elderly may also require special considerations before, during, and after the venipuncture procedure.
Mobility: Some elderly patients have difficulty walking or getting into or out of a chair. Using a chair that is an appropriate height so that the patient can safely get in and out of it will make it easier for the patient. Geriatric patients may also be unsteady on their feet. In such situations, the phlebotomist should react appropriately and walk alongside the patient, if necessary, to ensure patient safety.
Veins: The veins of an elderly patient may appear to "roll" when venipuncture is attempted. The vein is not actually moving, but rather the muscles surrounding the vein have lost tone and the vein is not as stable as in a younger patient. Therefore, the phlebotomist must anchor the vein firmly and securely when attempting venipuncture.
Skin: Skin may become thin and "papery" with advanced age. The phlebotomist must apply firm and prolonged pressure after venipuncture to prevent bruising. Use a bandage with a gentle adhesive to ensure stoppage of bleeding and promote skin integrity.
Health concerns: Some elderly patients take medications that could affect their bleeding or their balance. Be aware that these patients may require extra attention and time. Keep in mind, not all elderly patients experience hearing loss. Thus, the phlebotomist should not assume the patient is hard of hearing and shout at the patient while speaking to them. Most often, the patient will tell you to speak louder if they are unable to hear you.