WHAT IS AN ASSESSMENT?
“My 85-year-old widowed mother lives alone and has become increasingly forgetful, to the point of endangering herself. Her vision and hearing seem to be getting worse, and it has become very difficult for her to shop for groceries and prepare meals. She wants to stay at home. Is this possible? Is her physical condition going to get worse? Is her safety in greater jeopardy?”
“My widowed father is being discharged from the hospital after a stroke. The doctor says he can’t manage alone and must go to a nursing home. I work all day. Must he go to a nursing home? What care does he need and am I responsible for paying for it?”
“I am a 78-year-old widow living alone and feeling sad. I have no children and my close friend died eight months ago. My money doesn’t go very far. It’s almost impossible to keep up my apartment and take care of myself. What is wrong with me? Is there someone I can talk to?”
“I’ve lived with my husband for 58 years. Since his heart attacks 12 years ago, I’ve cared for him. I’m weary from arthritis and hardly able to get up and down the stairs. Can I get a housekeeper and someone to go to the stores for me? What happens to us when our money runs out.”
“My sister and I are in our eighties and live together in an apartment. We have always been close friends as well as sisters and I am terribly worried that she is showing signs of Alzheimer’s Disease or possible dementia. Her personality seems to have changed, she is not eating well and she becomes easily confused. She refuses to see her physician and I know she needs to be evaluated for proper care. I am frightened for both of us. What can I do?”
The point has come in these people’s lives when physical or emotional decline interferes with comfortable living. They can no longer care for themselves or manage their affairs without help. In order to help them, it is necessary to understand how their mental and physical impairments affect their daily living. This understanding comes as a result of an assessment (or evaluation) of the person’s needs, weaknesses, and strengths. It determines a person’s capacity for self care and takes into consideration available support from relatives and friends. In short, an assessment explores the physical, mental, emotional, social, and economic aspects of the person’s life to help determine a plan of care.
WHAT FACTORS ARE CONSIDERED IN AN ASSESSMENT?
- What is the chronic condition or illness for which the person needs help? What is the current and recommended treatment?
- What tasks can the person perform independently (e.g. shopping, cooking, grooming, toileting, moving about, or housekeeping)?
- Can the person follow directions, direct helpers, or manage his/her own affairs?
- Is the person affected by memory loss or impaired judgment?
- What support is available from relatives, neighbors, friends, or clergy to give care or monitor care at home?
- In what way does the physical layout of the person’s home help or hinder independent living? Can it be adapted, if necessary?
- What services are available in the community to meet the person’s needs? Does he/she meet medical, financial, and geographical criteria for these services?
- Given realistic choices, what are the person’s preferences for care?
- What is the person’s ability to pay for necessary services? If finances are limited, what financial assistance is available?
WHO DOES AN ASSESSMENT? WHERE IS IT DONE?
Currently, there are two basic types of assessments:
1. Medical Assessment:
In-Home: When the person is living at home, the assessment can be made by the family physician, a public heath nurse or a physician specializing in geriatric medicine. Contact your local hospital or the Nassau County Medical Society at 832-2300 for further information or referral.
Hospital-Based: When the person is in the hospital, a discharge planner or social worker will assist in securing needed services based on medical evaluations. It is imperative that someone establish contact with the Social Work Office as soon after admission as possible. On the basis of this medical evaluation, a plan of care is developed. Recommendations are then matched with appropriate and available services and programs in the community or in an institutional setting. In both cases, input from the older person himself, his family and other knowledgeable people, such as social workers and speech, physical and occupational therapists, is needed to make an accurate evaluation.
Geriatric: Some hospital physicians specialize in providing a comprehensive assessment of an older person’s health status by looking at all aspects of the individual’s social situation, nutritional needs, medication use, and mental and physical conditions. Physicians who specialize in this approach and can diagnose, treat, and manage diseases and conditions that are prevalent in an older population are called geriatricians. The following facilities offer this resource:
|Mercy Medical Center|
|Center for Geriatric Excellence|
|1000 N. Village Avenue||(516) 705-2525|
|Rockville Centre, NY 11570||www.mercymedicalcenter.chsli.org|
|North Shore-Long Island Jewish Health System|
|Geriatric Medical Services||(516) 708-2520|
|2800 Marcus Avenue||Evenings and Weekends: (516) 773-8974|
|Lake Success, NY 11042||www.northshorelij.com|
|South Nassau Hospital – Family Medicine|
|196 Merrick Road||(516) 255-8400|
|Oceanside, NY 11572||www.southnassau.org/services/family.cfm f|
|Winthrop University Hospital|
|Institute for Family Care – Geriatrics|
|259 First Street||(516) 663-2588|
|Mineola, NY 11501|
2. Social Worker or Case Manager’s Assessment:
This type of assistance is geared to frail elderly persons who require non-medical, in-home or community based services. Some older persons live alone, isolated from family and friends, with minimal financial resources, limited ability to care for themselves and little or no understanding of community services. To help these frail elderly, case management services are available through community agencies and social workers. The case manager assists in solving problems, coordinating supportive services and obtaining benefits and entitlements. Visits to the homebound are made when necessary Referrals for case management can be made by family, neighbors, business organizations, hospitals, etc. For further information, call:
NASSAU COUNTY OFFICE FOR THE AGING (516) 227-8900