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

11• older people suffering depression were not identified• it did not take account of the cost impact on subsequent service utilisation.Reflections on the Screening of Older PeoplePotential Risks of Screening Older PeopleScreening is not without its risks and nurses should consider the following issues carefully whenundertaking a screening programme with older people:• the sensitivity of highlighting problems not previously realised by the older person• expectations may be raised and solutions to their problems may not be found• there is a risk of intrusion of privacy, though this can be overcome by giving adequate explanationof the purpose of the assessment• it is important to remember that the person being assessed may be a carer.Benefits of Screening Older PeopleA screening programme for older people has benefits. These are:• the early identification of potential or actual problems• earlier referral and follow-up of problems• contribution to appropriate care planning• opportunity for primary prevention/health education• opportunity to give information about services and entitlements.Some Reflections on the Assessment ProcessWhile the comprehensive assessment process described uses a combination of tools in supportingprofessional judgement, it recognises that many older people have health and social care needs andthat professionals need to work together so that assessment and subsequent care planning is personcentred,effectivE and co-ordinated.Since the well-being of older people is often dependent on the effectiveness and health of familymembers, the assessment process should extend to include family carers. In our approach, thedependency levels are not measured by tools such as the Barthel Index and it could be argued thatthis makes it difficult to assess improvement in a person's functional or social ability. However, ifnurses are to be effective in their role, they need to adopt a holistic framework. This includes seeingthe experiences of older people as the older people themselves see them. It also means not reducingand compartmentalising people into quantifiable or measurable indices. Independent living is moredependent on the older person's own perspective and on psychological, environmental and socialfactors than on functional ability.III!IFinally, there is little point in screening persons unless services and treatments are available,acceptable and can influence the course and progress of a disease. A high detection rate can swampeXisting facilities, causing frustration and distress to all concerned ..Assessment of Older People's Health and Social Care Needs and Preferences