Why Is an Assessment Important?
An assessment is a powerful tool for proactively managing an older adult's health and well-being. It provides a holistic view of their needs, helping to identify potential risks and create a coordinated, forward-looking plan that maximizes their independence and quality of life. Instead of reacting to a crisis, an assessment allows caregivers and family members to make informed decisions about future care, housing, and financial planning.
Who Can Conduct an Assessment?
Depending on the scope and depth required, several professionals and organizations can perform an assessment for an elderly person. Some options are medical, while others focus on social and environmental needs.
Primary Care Physician (PCP)
Your first and most accessible option is often your loved one's PCP. They can conduct a basic health assessment, review medications for potential interactions, and screen for common age-related issues like cognitive decline or depression. If more complex issues are discovered, the PCP can provide a referral to specialists or other services. It is best to schedule a separate appointment specifically for this purpose rather than bringing it up at a routine check-up.
Geriatricians
For more complex or multiple chronic conditions, a geriatrician is the optimal choice. These physicians specialize in the care of older adults and have expertise in issues like polypharmacy, mobility problems, and dementia. A geriatrician-led assessment, often called a Comprehensive Geriatric Assessment (CGA), involves a multidisciplinary team and provides an in-depth evaluation of all aspects of the senior's health.
Area Agency on Aging (AAA)
These local agencies are invaluable resources for seniors and their families. An AAA can provide a needs assessment and connect you with a variety of local services, often at low or no cost. They can be the “Walmart of elder care,” coordinating with appropriate agencies to schedule an evaluation. The Eldercare Locator, a public service of the U.S. Administration for Community Living, can help you find your local AAA.
Aging Life Care Managers
These professionals, also known as geriatric care managers, are experts in navigating the challenges of aging. They can conduct a thorough, objective assessment of a senior's care needs and provide guidance and coordination for all aspects of their life. This service is private and typically comes with an hourly fee.
Home Health Agencies
Many home health agencies have trained staff, such as registered nurses or social workers, who can perform in-home assessments. They focus on evaluating needs that can be met through in-home care services, like housekeeping, meal preparation, or personal care. This can be a great way to get a feel for what care is needed and a good starting point for a senior who is reluctant to accept help.
Components of a Comprehensive Assessment
A comprehensive geriatric assessment goes beyond a simple health check-up, examining five key domains to build a complete picture of a senior's well-being:
- Functional Abilities: This evaluates the person's capacity to perform daily tasks independently. It is often broken down into two parts:
- Activities of Daily Living (ADLs): Basic self-care tasks such as bathing, dressing, eating, and using the toilet.
- Instrumental Activities of Daily Living (IADLs): More complex tasks related to independent living, including managing finances, shopping, cooking, and handling medications.
- Physical Health: A thorough medical review covering chronic conditions, medication management, and specialized screenings for issues like vision, hearing, nutrition, and fall risk.
- Mental and Emotional Health: Assessing cognitive function to identify signs of dementia or memory loss, as well as screening for mood disorders like depression or anxiety.
- Social Circumstances: Understanding the senior's social networks and support systems, including availability of informal support from family and friends.
- Environmental Issues: Evaluating the safety of the senior's living environment, looking for potential fall risks and identifying necessary modifications.
Preparing for the Assessment
Proper preparation can make the assessment more accurate and productive.
- Gather Information: Compile a list of all medications, including dosages and frequency, as well as a list of all doctors and specialists. Have any relevant medical records on hand.
- Make Detailed Notes: Over a week or two, keep a diary of your loved one's routines and challenges. Note any difficulties with daily tasks, changes in behavior, or specific incidents like a near-fall.
- Discuss and Include the Senior: Have an open conversation with your loved one about the assessment's purpose. Involve them in the process to respect their autonomy and ensure their preferences and goals are considered.
- Prepare Questions: Write down your questions and concerns in advance to ensure everything is addressed during the appointment.
Overcoming Reluctance
It can be challenging to convince a senior who is in denial or afraid of losing their independence.
- Engage the Doctor: If you are unable to persuade them directly, you can document your concerns and observations and send them to their primary care doctor. While HIPAA laws prevent the doctor from sharing information with you without consent, they can use your notes to guide their conversation with the patient.
- Position it as Routine: Frame the assessment as a routine annual wellness check or a normal part of getting older, rather than a sign of a problem.
- Focus on Your Concerns: Explain that you are concerned and that an assessment would help alleviate your worries. This shifts the focus from their perceived failings to your well-being.
- Involve Others: Sometimes a different family member or a trusted friend can break through the resistance.
Comparison of Common Assessment Resources
| Assessment Resource | Primary Focus | Typical Cost | When to Use |
|---|---|---|---|
| Primary Care Physician (PCP) | Basic health & medical needs | Varies, usually covered by insurance | As a first step, for known medical issues |
| Geriatrician | Complex medical & overall health | Varies, usually covered by insurance | For multiple chronic conditions or complex needs |
| Area Agency on Aging (AAA) | Social services & community resources | Low-to-no cost | For those on a budget or needing access to local programs |
| Aging Life Care Manager | Comprehensive care management | Hourly fee ($$$) | For complex situations, family disagreements, or long-distance caregiving |
| Home Health Agency | In-home care & personal needs | Varies, some coverage possible | To evaluate needs for services at home |
Conclusion
Navigating the process of getting an assessment for an elderly person is a proactive and compassionate step toward ensuring their safety, independence, and overall quality of life. By understanding who can perform an evaluation, what to expect, and how to approach sensitive conversations, caregivers can successfully initiate this critical process. The ultimate goal is not to remove independence but to empower seniors with the right support, allowing them to age with dignity and security in their preferred environment. Start by gathering information and reaching out to the appropriate professionals, whether it's your loved one's PCP or a local Area Agency on Aging. A proactive approach now can lead to better outcomes for everyone involved.
Note: A powerful tool for locating a range of senior resources and services in your area is the Eldercare Locator, provided by the Administration for Community Living.
