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The development of a geriatric assessment instrument for long term care facilities

University of British Columbia

The purpose of the study was to design a reliable and valid assessment instrument that would provide a multidimensional profile of the elderly resident of a long term care facility. Use of this instrument would be a method of collecting and corrmunicating information concerning the full range of problems experienced by this group, in a form that is suitable for use at different levels of decisionmaking. The instrument consists of 31 unweighted items measuring functioning in 5 essential areas - cognitive, physical, emotional, social, and instrumental. Ratings were based on the observations of long term care staff who were in close contact with the individual over extended periods. Reliability and validity were tested using a non random sample of 76 elderly residents of one extended care unit. Both test-retest and interjudge reliability proved to be high and item analysis indicated that, with the exception of 2 items, the instrument provides levels of functioning appropriate to the sample population. The instrument also showed a high degree of internal consistency with the 3 major components identified as - cognitive behaviour, independence in daily living, and physical functioning. The validity of the instrument and its subsections was demonstrated through significant relationships with external criteria, namely - the number of problems listed on the multidisciplinary problem-oriented record, a health index measure, and a mental status rating. Further evidence of the instrument's validity was its ability to predict, retrospectively, 72 percent of the sample deaths in the first year following admission. Although only a preliminary form of analysis, this showed that a high level of mental functioning, combined with a low level of independence in daily living, was predictive of death within 3 to 9 months in the sample population. The implications of these results are discussed along with suggestions for further research in the area. Finally, potential uses for the assessment instrument in the field of long term care are provided.

Text

2010-03-03

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http://hdl.handle.net/2429/21463

Nursing

University of British Columbia

Graduate