© Mizukami, Airisu C.
* CHAPTER 10
* FUNCTIONAL ASSESSMENT USED WITH OLDER ADULTS
Health in Old Age
* Is a complex, elusive concept.
* Experiencing normal developmental age changes such as gradual changes in endurance, vision, hearing & reflex timing.
* Some problems in old age due to a long-term disuse of physical & mental abilities:
* Back problems due to lifelong postural habits or long use of sagging mattress.
* New widow may struggle to make independent decisions regarding home maintenance.
* Traumatic injury may occur such as hip fracture or CVA.
* Trauma, whether physical or psychological, occurs in conjunction with chronic ...view middle of the document...
Barthel Self-Care Index
* Originally designed as a measure of function in the physically impaired, it has been used extensively in research & treatment planning with older people.
* Hasselkuls described the use as an index that measures basic self-care skills of feeding, transfer, personal hygiene, toileting, bathing, ambulation, stairs, dressing, & bowel & bladder continence.
* Scoring is based on observation of performance & preferential weighting has been given to items of continence & mobility.
* Was used in four ways:
* To help define the amount & type of personal care services required by patients to be maintained in the community
* To document change over time
* To better define variables associated with discharge/ placement decisions
* To help clarify the impact of community health services on the ability of the family to maintain care of an older member over a long period of time.
Parachek Geriatric Behavior Rating Scale
* Quick screening device of 10 multiple choice items.
* Three questions on physical condition, four on general self-care, & three on social behaviors.
* Each question is scored on a 5-point Likert-type scale of performance, with 1 being the most impaired. The final score is the sum of 10 individual ratings.
* This scale was derived from the longer Plutchik Geriatric Rating Scale.
* Group I are patients scoring in the 10-24 range; treatments include positioning, sensory stimulation, motor patterns & group process.
* Group II patients scoring 25-39 range; includes self-care activities, contact with the community, & adaptation for wheelchair patients.
* Group III patients are the highest functioning group with scores 40-50; they can manage most self-care activities & maybe candidates for placement in community setting.
Short Portable Mental Status Questionnaire
* Is used extensively by physicians & other health personnel to detect intellectual impairment.
* There are 10 questions to be asked & three or four error indicates a moderate to severe impairment.
New Instruments Developed by Occupational Therapists
Assessment of Occupational Functioning
* Is an occupational device based on the model of human occupation.
* It is a semi-structured interview schedule to assess physically & psychologically impaired residents...