How do you combine assessments? Let’s again take a caregiver assessment and functional assessment. In your functional assessment you have found the older client has a self-care deficit. They have a family caregiver yet their clothes are dirty and they are not being bathed on a regular basis. When you do your caregiver assessment you find that the family caregiver, the aging spouse, is not only depressed but also burnt out. They have been caring for the husband for 7 months are exhausted and skipped critical care giving tasks. Adult children are aware of this and called you, the geriatric care manager or aging professional, to do a geriatric assessment. You can list both older client self-care deficit, caregiver burnout and need for informal support (the adult children) as problems in your care plan. You can also list need for formal support –(a caregiver support group, a private duty home care agency) as a problems in your care plan. You are calling attention multiple main problems – why they need a caregiver, the problems with the caregiver and extended family in a brief, through, and connected list in your care plan. This is just what you need in a care plan under problems. You have derived the problems from two separate assessments yet connected them in the care plan.
How do you connect aging client assessments? For example, if you find through your functional assessment that the client’s clothes are dirty and they are not bathing, start with self care deficit in your care plan then list that manifestation of the problem. If you find your caregiver assessment that the family caregiver is depressed and angry and is on the edge of placing the older person even if they are at the level of care- start with caregiver burnout and then list the manifestation of that burnout. You have then connected two different assessments.
If you have an elderly client is need of your geriatric care management or elder care services initially you do psychosocial and functional assessment Next you feel depression is present so you do a Geriatric Depressionscale. You always screen for dementia so you do a mental status exam . You make a home safety assessment part of every client assessment so you complete a home safety assessment. Then you have an exhausted caregiver who is a live-in girlfriend, up in age herself so you so a caregiver assessment . Do you do a care plan with each of these assessments? Yes, Do you give the family trust officer, third party seven care plans? No. All care plans are integrated into one care plan. How do you do this? We will be covering this is my next blog.
Other nations are ahead of the United States in recognizing the needs of caregivers. In Ireland Liam O’Sullivan, Executive Director, Care Alliance shared their case for as they call them “carer”. Assessments http://www.carealliance.ie/userfiles/file/The%20Case%20for%20Carers%20Assessments%20June%202012.pdf
Other countries have seen what the US has yet to grasp. In the United Kingdom a seminal law passed in 1995 called the Recognition and Services Act http://www.legislation.gov.uk/ukpga/1995/12/section/1, which provided British caregivers a statutory right to request an assessment at the same time that a frail elder or adult with disabilities is assessed.
Why are we so far behind?