What should be the first step when assessing an 86-year-old patient presenting with osteoarthritis in the wrists and hands?

The initial step in assessing an 86-year-old patient with osteoarthritis in the wrists and hands should be to ask which activities of daily living (ADLs) are most difficult or painful for them. This approach prioritizes the patient's personal experience and functional limitations, directly linking their condition to how it affects their day-to-day life. Understanding which specific tasks are challenging allows the healthcare provider to tailor the assessment and subsequent treatment plan to address the patient's most pressing concerns.

Moreover, gaining insight into the patient's difficulties with ADLs can help identify the severity and impact of their osteoarthritis within the context of their daily activities. This patient-centered approach also fosters open communication, enabling the patient to express their needs and concerns, which is crucial for building a trusting relationship and ensuring effective care.

Subsequent assessments, such as evaluating range of motion, mobility, and pain levels, can then be guided by the understanding gained from the patient's responses, ensuring a comprehensive and relevant assessment process.