Characteristics of and Barriers to Functional Status Assessment in Assisted Living

Abstract

The most commonly used functional status (FS) instruments were examined to determine the validity, reliability, sensitivity, and specificity to change and feasibility in residents in an assisted living facility (ALF). Twenty-six ALF residents were assessed weekly for up to 8 months using six instruments. Group and single-subject analyses were used to examine associations between instruments and acute events. Two were problematic initially (Katz Index of Independence in Activities of Daily Living and hand grip) and were excluded early in the study. Of the remaining instruments, only the Barthel Index and Resident Assessment Instrument had acceptable psychometric profiles. However, these instruments were either not feasible in this environment or did not capture the full range of FS in this population. The current study's findings suggest that instruments commonly used to measure FS may be inadequate for this population and environment. These findings may be used to develop assessment methods for ALF residents that capture both the full range of FS in ALF settings as well as acute and long-term changes in functioning.

Exploring Path Models of Disablement in Residential Care and Assisted Living Residents

“…Other researchers have reported similar psychometric issues with the Barthel Index (Poulsen, Hesselbo, Pietersen, & Schroll, 2005). Additionally, a recent psychometric study determined that none of the six instruments tested, of which the Barthel Index was one, were adequate for measuring functional status in the assisted living population (Bowen, Rowe, Hart-Hughes, Barnett, & Ji, 2015). Because existing functional status or ADL instruments were not originally developed for the RC/AL population, many include items that may be irrelevant to RC/AL environments, such as stair climbing in the Barthel Index or carrying groceries 70 meters in another established tool, the Continuous Scale Physical Functional Performance test (Cress et al, 1996).…”

Traducción y adaptación cultural del cuestionario de independencia física Composite Physical Function para su uso en Chile

“…En un tercer aspecto de análisis, el CPF es un instrumento que demostró ser de fácil comprensión y adaptación al idioma y la cultura, como se ha mencionado anteriormente. Sin embargo, otros instrumentos ampliamente utilizados como el Índice de Barthel 10 y el Índice de Katz 11 presentan mayores detalles para poder explicar las diversidad de opciones que pueden haber asociado a las actividades en particular y las diferencias de desempeño, lo cual resulta una fortaleza al comparar con la sobriedad y concisión del CPF para realizar el planteamiento de cada punto 17 . El instrumento FIM se realiza mediante entrevista para indagar opciones personales que dan relevancia a variaciones culturales, geográficas y de contexto socioeconómico que sean de consideración para el análisis 18 .…”

A research proposal testing a new model of ambulation activity among long-term care residents with dementia/cognitive impairment: the study protocol of a prospective longitudinal natural history study

“…However, most residents in long-term care have a history of falls (mean 1.7 falls per bed/annually) [6] and gait and balance impairments. The timing of these fall assessments vary by NH, but are typically administered on admittance, quarterly, and/or every 6 months [7–9]. In addition, these assessments are usually administered outside of the natural environment—e.g., in controlled conditions in front of a clinical observer which may vary results [10, 11].…”

“…It would also be difficult to implement continuous observations by staff as these are time-consuming. Thus, there is a critical need for more objective, continuous measures of ambulation that automatically ‘observe’ the resident’s day-to-day activities in their natural environment [7, 12, 13]. Furthermore these continuous measures must be combined with ongoing data analysis to detect a change and report that change to health care staff.…”