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The making of a self-neglect severity scale
- Authors:
- DYER Carmel B., et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 18(4), 2007, pp.13-23.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Although self-neglect is the most common allegation reported to Adult Protective Agencies in the USA, there is a dearth of research on the problem, in part because of the lack of a standardised and validated measurement scale. This paper briefly describes the Self-Neglect Severity Scale by the Consortium for Research in Elder Self-Neglect of Texas (CREST). This was developed on the basis of interviews with Adult Protective Services staff and a national expert panel, piloted, field tested and subsequently revised. The CREST SSS encompasses observational ratings, interview responses, an assessment of the physical and environmental domain, and an assessment of functional status in relation to health and safety issues. It has been demonstrated to be both reliable and valid. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
An evaluation of assessment tools used for older people with complex health and social care needs
- Authors:
- MCCORMACK B.G., et al
- Publisher:
- Northern Ireland. Department of Health, Social Services and Public Safety
- Publication year:
- 2007
- Pagination:
- 30p., bibliog.
- Place of publication:
- Belfast
This study examined current assessment instruments used in Northern Ireland used to assess the abilities and needs of older people. To instruments general applicability according to accreditation principles outlined as good practice by the Department of Health were examined. The coverage of the instruments according to the nine domains and 40 sub-domains of the National Service Framework for Older people were also examined. Eleven instruments were received from all Trusts providing community health and social care services. The instruments were then analysed looking at areas of good practice and the domains of assessment. Findings include: general assessment did not capture the perceptions of an older person regarding their health and social care needs or how their quality of life is affected by loss of ability; the level of participation by the older person in their assessment was unclear; considerable variability in the level of coverage of all nine domains within different Trust documentation. The findings support the necessity for to develop a standardized instrument; standardized on the level of assessment on each domain and standardized across all trusts.
Prospects and pitfalls: use of the RAI-HC assessment by the Department of Veterans Affairs for home care clients
- Authors:
- HAWES Catherine, et al
- Journal article citation:
- Gerontologist, 47(3), June 2007, pp.378-387.
- Publisher:
- Oxford University Press
The U.S. Department of Veterans Affairs has adopted two functional assessment systems that guide care planning: one for nursing home residents (the Resident Assessment Instrument [RAI]) and a compatible one for home care clients (RAI-HC). The purpose of this article is to describe the RAI-HC (often referred to as the Minimum Data Set–Home Care or MDS-HC) and its uses and offer lessons learned from implementation experiences in other settings. The study reviewed implementation challenges associated both with the RAI and the RAI-HC in the United States, Canada, and other adopter countries, and drew on these to suggest lessons for the Department of Veterans Affairs as well as other entities implementing the RAI-HC. Beyond its clinical utility, there are a number of evidence-based uses for the assessment system. The resident-level data can be aggregated and analyzed, and scales identify clinical conditions and risk for various types of negative outcomes. In addition, the data can be used for other programmatic and research purposes, such as determining eligibility, setting payment rates for contract care, and evaluating clinical interventions. At the same time, there are a number of implementation challenges the Department of Veterans Affairs and other organizations may face. Policy makers and program managers in any setting, including state long-term-care programs, who wish to implement an assessment system must anticipate and address a variety of implementation problems with a clear and consistent message from key leadership, adequate training and clinical support for assessors, and appropriate planning and resources for data systems.
Rapid needs assessments for older adults in disaster
- Author:
- BURNETT Jason
- Journal article citation:
- Generations, 31(4), Winter 2007, pp.10-15.
- Publisher:
- American Society on Aging
The author describes the use of a Rapid Needs Assessment tool to assess the needs of victims of Hurricane Katrina. The tool was specifically designed to identify the needs of older people in disaster situations.
Self-report measures of anxiety: are they suitable for older adults?
- Authors:
- DENNIS R. E., BODDINGTON S. J. A., FUNNELL N. J.
- Journal article citation:
- Aging and Mental Health, 11(6), November 2007, pp.688-677.
- Publisher:
- Taylor and Francis
To assess the performance of four self-report measures of anxiety in an older adult population. Forty older adults with current or previous anxiety symptoms completed four self-report measures of anxiety (Beck Anxiety Inventory, State Trait Anxiety Inventory, Hospital Anxiety and Depression Scale and Visual Analogue Scale) and received an independent diagnostic assessment and rating of anxiety severity. After a minimum of four months, participants were re-assessed on all measures. The self-report measures most suited for anxiety screening and assessing severity when compared to the independent assessment were the Beck Anxiety Inventory (BAI), the anxiety scale from the Hospital Anxiety and Depression Scale (HADS-A) and State Trait Anxiety Inventory-Trait form (STAI-T). However, participants made an unacceptably high number of errors using the STAI-T, making the BAI and HADS-A the most suitable measures for older adults. The Visual Analogue Scale (VAS) performed poorly in both screening and measuring severity. All self-report measures were poor at detecting change as evaluated by the independent assessment. There was no single measure that performed adequately in screening, measuring severity and monitoring changes, suggesting that measures may need to be adapted if they are to be used in an older adult population. The lack of appropriately designed self-report measures with adequate normative data for older people presents a barrier to future research.
Factors associated with higher quality assessment tools in care homes
- Authors:
- WORDEN Angela, CHALLIS David
- Journal article citation:
- Journal of Care Services Management, 2(1), October 2007, pp.79-91.
- Publisher:
- Taylor and Francis
This paper investigates the relationship between the quality of assessment tools used in care homes and the different characteristics of care homes in part of North-West England. Using both single variable comparisons and multivariate analyses there were several home characteristics associated with the use of higher-quality assessment tools. Higher-quality assessment process were associated with homes being larger, part of a group or chain, provision of staff training and run by non-for-profit organisation or local authority. Poorer quality of assessment was associated with inspection reports indicating lower standards of management and staffing and generally poorer quality of the home. The findings raise the question as to whether government initiatives to improve assessment of older people should be extended to care homes, with a need to focus on certain types of home where assessment is less likely to be well developed.
Seven minute screen performance in a normal elderly sample
- Authors:
- SKJERVE Arvid, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.764-769.
- Publisher:
- Wiley
The Seven Minute Screen (7MS) is a brief cognitive case-finding instrument for dementia. The test is composed of four subtests that assess performance with regard to orientation, memory, visuospatial ability and language. The objective of this study was to describe 7MS performance in a normal sample of Norwegian people aged 65 years and older. The subjects were 66 Norwegian community-dwellers who met selection criteria modified from the Mayo Older American Normative Studies standard. Mean age was 73.2 years, age range was 65-93 years, and mean Mini-Mental State Examination score was 29.06, range 26-30. Analysis of the 7MS subtests revealed relatively modest influence of age, education and gender on test performance. The composite 7MS performance scores were associated with education. Normal performance was expressed as means, standard deviations and percentile values for the age groups 65-74 years and 75 + years. 7MS performance is described for a normal sample. These data have the potential to increase the clinicians' ability to interpret 7MS test results.
Self-administered cognitive screening for a study of successful aging among community-dwelling seniors: a preliminary study
- Authors:
- MOORE David J., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(4), April 2007, pp.327-331.
- Publisher:
- Wiley
Cognitive functioning is a central component of successful aging. Yet, there are few published instruments for brief and reliable self-administered cognitive assessment that could be used in large population-based studies of community-dwelling elderly people. This American study examined the utility of a self-administered cognitive screening instrument in a group of community-dwelling older adults, and evaluated correlations of the performance on this measure with demographic variables and specific indicators of self-rated successful aging. The authors assessed 182 well-educated adults ages 58 to 99 with a modified version of a previously published cognitive screening instrument (Cognitive Assessment Screening Test - Revised; CAST-R), a measure of cognitive complaints (Cognitive Failures Questionnaire; CFQ), and a self-rating of successful aging. The SF-36 Physical and Mental Composite Scores was used as a measure of physical and mental health-related functioning. As expected, most individuals performed well on the CAST-R; only 7% of participants fell below a previously established cut score for cognitive impairment. CAST-R scores were positively correlated with level of education, income, SF-36 Mental Composite Scores, and a self-rating of successful aging, and negatively correlated with chronological age. Scores on the CAST-R were not correlated with cognitive complaints (CFQ total score) or SF-36 Physical Composite Scores. It is concluded that a self-administered cognitive screening tool may be a useful, albeit limited, way of screening for cognitive disabilities among well-educated, community-dwelling older adults. Although preliminary, significant associations with several successful aging-related variables in expected directions represent the first step in establishing the validity of the CAST-R.
The validity of the core element of the Northern Ireland single assessment tool (NISAT) for the health and social care of older people
- Authors:
- MCCORMACK B.G., et al
- Publisher:
- Northern Ireland. Department of Health, Social Services and Public Safety
- Publication year:
- 2007
- Pagination:
- 55p.
- Place of publication:
- Belfast
The Northern Ireland Single Assessment Tool (NISAT) was developed to address the assessment process as highlighted in the NSF for Older People. The NISAT consists of three main parts: the Contact Screening; the Core NISAT; and the Complex NISAT. The Core assessment consists of eight domains covering all areas of the older people's life - mental health; communication and sensory functioning; personal care and daily tasks; mobility and movement; awareness and decision making; accommodation and living arrangements; employment, finance and leisure; and physical health and medication. Each domain is measure using a combination of qualitative and quantitative measures. This study aimed to develop and test a measure of validity that incorporates both qualitative and quantitative measures. Assessors were trained how to use the draft NISAT instrument. The theoretical definition given to each domain was then rated against the assessors own views. All professional groups felt the core NISAT was valid. The findings did highlight the need for tailored and individualized training programmes n the use of the instrument. Appendices include sample instructions and scoring sheets for two domains.
Comparison of the diagnostic accuracy of the Cognitive Performance Scale (Minimum Data Set) and the Mini-Mental State Exam for the detection of cognitive impairment in nursing home residents
- Authors:
- PAGUAY Louis, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(4), April 2007, pp.286-293.
- Publisher:
- Wiley
This study aimed to compare the diagnostic accuracy of an outcome measurement scale of the Minimum Data Set of the Resident Assessment Instrument for nursing homes (MDS/RAI-NH), the Cognitive Performance Scale (CPS) and the Mini-Mental State Exam (MMSE) for the detection of cognitive impairment. The Cambridge Examination for Mental Disorders of the Elderly - Revised (CAMDEX-R) was used as the reference standard. This study was part of a larger prospective study (QUALIDEM) involving a diagnostic procedure and two-year follow-up on the quality of primary care for demented patients. CAMDEX-R and MDS/RAI-NH were administered to 198 residents, aged 65 or more, living in 42 low and high care institutions for older people in Belgium. Main outcome measures used were indicators of diagnostic accuracy: sensitivity, specificity, predictive values, likelihood ratios, odds ratio and area under receiver operating characteristics curve (AUC). The CAMDEX-based prevalence of cognitive impairment was 75%. The results found that CPS and MMSE demonstrated similar performance to detect cognitive impairment in nursing home residents.