$Unique_ID{BRK01326} $Pretitle{} $Title{Functional Assessment} $Subject{nursing home assessment aging mental emotional conditions community social problems functional assessments homes independent activities daily living adl instrumental iadl condition age aged old older elderly geriatric geriatrics lifestyle lifestyles independence} $Volume{E-23,T-23} $Log{} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Functional Assessment ------------------------------------------------------------------------------ QUESTION: We have come to a sad time in our lives and now need your help badly. Though confused by many past events we believe it is time to find a place for Dad to live, for we don't think he can continue to make it on his own, alone at home. Still we want to make a rational decision about this. Are there any tests or examinations that might help us with this difficult decision? Who can we turn to for help? ------------------------------------------------------------------------------ ANSWER: Many specialized units in medical centers, as well as a growing number of community hospitals, community service agencies, primary care physicians and their staffs, are using quick, standardized tests to help determine whether an older person can care for himself. This procedure, called functional assessment, is a way to identify conditions that may match a person's ability to lead an active and independent life. It also can be used to monitor the progress of therapy that may be started when evaluation shows the need for help. Assessment teams are often headed by physicians, and may include nurses, social workers, physical or occupational therapists, and others. Assessment is useful not only for people who are living alone, but also for those who are living with their families, in nursing homes, or in hospitals. One of the goals of assessment is to reduce the cost of care, while giving the person the help he needs to be as independent as possible. It also helps in determining the best facility to meet with the needs of the patient. The team collects information on the person's physical and mental activity, how he acts, and his social and economic situation. You, as a member of the family, can not only help to provide this information, but also to give your father the emotional and physical support that are important for successful evaluation--everything from making sure he arrives at his appointments on time feeling relaxed, to discussing with him any concerns he may have about the assessment or the reasons for undergoing it. A typical part of the analysis might be an Activities of Daily Living (ADL) Index. It is used to find out how much assistance, if any, your father needs to bathe, dress, move about, eat, and go to the bathroom. Another test, called the Instrumental Activities of Daily Living (IADL), covers using the phone, shopping, cooking, housekeeping, doing laundry, using transportation, handling medications, and managing money. Whether these specific tests are used or not, the assessment may involve a number of evaluations conducted in one or more sessions. Although you may want to accompany your father, as you will be able to furnish useful information to the team, they will probably also want to interview your father directly, and may ask you to leave the room. In addition, his medical records will be checked to provide a complete evaluation of his medical and emotional condition. Your task is not an easy one, but is being faced by more and more families each day. It is hard to face the fact that a loved parent may do better in a controlled and structured environment, but I believe you will find that after a brief period of adjustment, your Dad will do better, and enjoy life more than he would have in the solitude of single living. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.