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`Introducing yourself to strangers'

Nurses' views on assessing older people with complex care needs

Head of Centre for Health Economics and Policy Studies School of Health Science Swansea University, S.E.Lambert{at}swansea.ac.uk

Valerie Thomas

Tutor in Health Policy School of Health Science Swansea University

Lyn Gardner

School of Health Science Swansea University

The aims of this study were to explore the practicability of two instruments developed to assess older people with complex care needs and to assess compliance with criteria for assessment tools that require tools to be person-centred and to support rather than replace professional judgement. Nurse assessors undertook assessments of older people living in a care-home setting or awaiting discharge from hospital, using EASY-Care and Minimum Data Set Resident Assessment Instrument (MDS-RAI). The results suggest that both tools are practicable and useful in enabling older people to identify their needs. EASY-Care was preferred to identify both health and social-care needs. It was considered to be more person-centred in that open-ended questions allowed people to describe their circumstances in their own words. Its style made it easier to develop rapport with older people and encouraged them to talk and to disclose information beyond the immediate scope of the tool itself. Nevertheless some questions provoked anxiety and assessors needed to use their professional judgement in order to achieve a person-centred, appropriate assessment. MDS-RAI appeared to be more useful in identifying nursing or medical issues. But it did not always reveal a complete picture of the person's care needs and situation. Some nurses suggested that MDS-RAI was useful in circumstances where, in their professional judgement, older people were not being realistic in discussing their needs and their expectations for future care. The findings identify how nurses can use tools to support their assessment skills.

Key Words: nurses • older people • assessment tools • professional judgement

Journal of Research in Nursing, Vol. 12, No. 4, 349-360 (2007)
DOI: 10.1177/1744987107075663


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