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

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--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
Pathways to Care Old AgeScreening and Assessment inthe Community Using theWinchester Disability RatingScale (WDRS):1IGeraldine Tabb, Director of Public Health Nursing, South Eastern Health BoardThis paper concerns the piloting of the Winchester Disability Rating Scale (WDRS) as an approach toold age screening and assessment in the community in the Waterford Community Care area of theSouth Eastern Health Board region.Rationale for the Pilot ProjectThere were a number of reasons why we, as Public Health Nurses, decided to pilot the WinchesterDisability Rating Scale in our work with older people. These were:• the requirement to plan services• the need to plan and develop our anticipatory care of older people as opposed to crisis intervention• the requirement to develop suitable 'packages of care' for older people• the need to develop an 'at risk' register for older people in the community• the fact that the commonly-used Barthel scale was insufficient on its own to measure the needs of older people• the lack of standardised reliable instruments for use in our screening and needs assessmentprocesses with older people.The Winchester Disability Rating Scale ...The Winchester Disability Rating Scale is a fifteen item instrument designed to measure anindividual's ability to perform the activities of daily living (ADL).It includes sub-scales which measure:• activitip.s of daily living (ADL)• social care• mental healthAssessment of Older People's Health and Social Care Needs and Preferences
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