Assessment of Older People's Health and Social Care Needs and ...

--Assessment Levels and ToolsAny assessment we do can be conducted at three levels: the basic level which looks at functionalactivities and personal care, the instrumental or intermediate level which is concerned with tasks ofmoderate complexity, such as shopping, doing the laundry, self medications, the advanced activitiesof daily living, for example, the occupational or recreational activities of the older person.In the Southern Health Board, the assessment tools that we are using include the Barthel Index, theAbbreviated Mental Test (AMT) and the Mini Mental Test Exam (MMSE). Each has its strengths andlimitations. The Barthel Index looks at functional activities only and does not cover social activities.The AMT looks at orientation and gives a global measure of mental health. The MMSE attempts tomeasure cognitive and behavioural tasks, but is open to misinterpretation. For example, a welleducatedolder person can cover up some cognitive difficulties and score a false positive. Equally, apoorly-educated older person can score a false negative.Ageing with Confidence'Ageing with Confidence' is the strategy which expresses our vision for the development of servicesfor older people in Cork and Kerry. It provides a framework for service development andimplementation, has informed our planning process and incorporates an agreed assessmentapproach. What we are working towards, within the direction provided by 'Ageing with Confidence',is an assessment process that is:continuousinclusive of both carers and patientspatient-centredenabled by the sharing of information from other professionals and agenciessupported by reflective practice on the part of the professionals involvedhas links between assessment outcomes and evaluation.__1-------------I would like to leave you with a comment from Muir Grey who suggested that, in the health caresector:• the 1970s had been about doing things cheaper• the 1980s about doing things better• the 1990s about doing the right things• the twenty-first century would be about doing the right things right'.2. Grey, M. (1997), Evidence Based Health care, Sage: LDndon.Conference Proceedings