Prospects and Pitfalls: Use of the RAI-HC Assessment by the Department of Veterans Affairs for Home Care Clients

Hawes, Catherine; Fries, Brant E.; James, Mary L.; Guihan, Marylou

doi:10.1093/geront/47.3.378

Cited by 31 publications

(46 citation statements)

References 32 publications

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“…Although the RAI‐HC has been reported to be reliable, there is no assurance that the data represent the reality of day‐to‐day care, due to their subjective nature. The RAI‐HC records the functional aspects of hearing and vision; however, it is unable to objectively quantify these impairments . For example, sensory impairment was classified using the items in the RAI‐HC, where scores of hearing and vision functions were assigned by a health care professional on the basis of interviews with older adults.…”

Section: Introductionmentioning

confidence: 99%

“…The RAI-HC records the functional aspects of hearing and vision; however, it is unable to objectively quantify these impairments. 6 For example, sensory impairment was classified using the items in the RAI-HC, where scores of hearing and vision functions were assigned by a health care professional on the basis of interviews with older adults. In comparison, ETDRS charts, which use logarithmic minimum angle of resolution (logMAR) units, and are presented in numerical format, are a gold standard in ophthalmic research.…”

Section: Introductionmentioning

confidence: 99%

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The impact of sensory impairment on cognitive performance, quality of life, depression, and loneliness in older adults

Harithasan

Mukari

Ishak

et al. 2019

Int J Geriat Psychiatry

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Objectives The objective of this study was to evaluate the relationship between sensory impairment (hearing loss only, vision loss only, and dual sensory impairment [DSI]) and depression, loneliness, quality of life, and cognitive performance in older adults. Methods A total of 229 community‐dwelling older adults aged 60 years or older participated in this study. Variables were measured using the Geriatric Depression Scale (GDS‐15), Revised University of California at Los Angeles Loneliness Scale (R‐UCLA), Satisfaction with Life Scale (SWLS), and Mini‐Mental State Examination (MMSE). Results There was an independent association between DSI and quality of life (P < .05) and between DSI and hearing loss alone and cognitive function (P < .05) in older adults. In addition, higher education was associated with better quality of life and cognitive function. Conclusions DSI is a significant factor affecting the quality of life and cognitive function in older adults. Sociodemographic factors such as education play an important role in improving quality of life and cognitive function. Thus, increasing the awareness of this disability is important to ensure that older adults receive the necessary support services and rehabilitation to improve their level of independence.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of sensory impairment on cognitive performance, quality of life, depression, and loneliness in older adults

Harithasan

Mukari

Ishak

et al. 2019

Int J Geriat Psychiatry

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“…In addition, PNs are trained to administer the Resident Assessment Instrument – Home Care (RAI-HC), a standardised and extensively validated instrument for broad functional assessment of elderly patients and their informal caregiver [10]. They learn to make a care plan based on the RAI results and evaluate it periodically.…”

Section: Methods and Designmentioning

confidence: 99%

Case-finding of dementia in general practice and effects of subsequent collaborative care; design of a cluster RCT

et al. 2012

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BackgroundIn the primary care setting, dementia is often diagnosed relatively late in the disease process. Case finding and proactive collaborative care may have beneficial effects on both patient and informal caregiver by clarifying the cause of cognitive decline and changed behaviour and by enabling support, care planning and access to services.We aim to improve the recognition and diagnosis of individuals with dementia in general practice. In addition to this diagnostic aim, the effects of case finding and subsequent care on the mental health of individuals with dementia and the mental health of their informal carers are explored.Methods and designDesign: cluster randomised controlled trial with process evaluation.Participants: 162 individuals ≥ 65 years, in 15 primary care practices, in whom GPs suspect cognitive impairment, but without a dementia diagnosis.Intervention; case finding and collaborative care: 2 trained practice nurses (PNs) invite all patients with suspected cognitive impairment for a brief functional and cognitive screening. If the cognitive tests are supportive of cognitive impairment, individuals are referred to their GP for further evaluation. If dementia is diagnosed, a comprehensive geriatric assessment takes place to identify other relevant geriatric problems that need to be addressed. Furthermore, the team of GP and PN provide information and support.Control: GPs provide care and diagnosis as usual.Main study parameters: after 12 months both groups are compared on: 1) incident dementia (and MCI) diagnoses and 2) patient and caregiver quality of life (QoL-AD; EQ5D) and mental health (MH5; GHQ 12) and caregiver competence to care (SSCQ). The process evaluation concerns facilitating and impeding factors to the implementation of this intervention. These factors are assessed on the care provider level, the care recipient level and on the organisational level.DiscussionThis study will provide insight into the diagnostic yield and the clinical effects of case finding and collaborative care for individuals with suspected cognitive impairment, compared to usual care. A process evaluation will give insight into the feasibility of this intervention.The first results are expected in the course of 2013.Trial registrationNTR3389

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“…The RAI tools help to standardize client assessment and form an evidence base to influence clinical practice and policy decisions and thus have been mandated by many organizations [17]. Within community settings, such as HC and SL, the RAI-HC is a useful tool for highlighting themes related to functioning and quality of life of clients [18]. The RAI-HC quality indicators can be assessed and recorded and include categories such as pain, falls, or depression [18].…”

Section: Introductionmentioning

confidence: 99%

“…Within community settings, such as HC and SL, the RAI-HC is a useful tool for highlighting themes related to functioning and quality of life of clients [18]. The RAI-HC quality indicators can be assessed and recorded and include categories such as pain, falls, or depression [18]. The assessment data contained within the RAI-HC is easily accessible and, therefore, can be used to assess trends or patterns in client quality indicators.…”

Section: Introductionmentioning

confidence: 99%

Data for improvement and clinical excellence: protocol for an audit with feedback intervention in home care and supportive living

et al. 2012

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BackgroundAlthough considerable evidence exists about the effectiveness of audit coupled with feedback, very few audit-with-feedback interventions have been done in either home care or supportive living settings to date. With little history of audit and feedback in home care or supportive living there is potential for greater effects, at least initially. This study extends the work of an earlier study designed to assess the effects of an audit-with-feedback intervention. It will be delivered quarterly over a one-year period in seven home care offices and 11 supportive living sites. The research questions are the same as in the first study but in a different environment. They are as follows:1. What effects do feedback reports have on processes and outcomes over time?2. How do different provider groups in home care and supportive living sites respond to feedback reports based on quality indicator data?MethodsThe research team conducting this study includes researchers and decision makers in continuing care in the province of Alberta, Canada. The intervention consists of quarterly feedback reports in 19 home care offices and supportive living sites across Alberta. Data for the feedback reports are based on the Resident Assessment Instrument Home Care tool, a standardized instrument mandated for use in home care and supportive living environments throughout Alberta. The feedback reports consist of one page, printed front and back, presenting both graphic and textual information. Reports are delivered to all employees working in each site. The primary evaluation uses a controlled interrupted time-series design, both adjusted and unadjusted for covariates. The concurrent process evaluation includes observation, focus groups, and self-reports to assess uptake of the feedback reports. The project described in this protocol follows a similar intervention conducted in our previous study, Data for Improvement and Clinical Excellence--Long-Term Care. We will offer dissemination strategies and spread of the feedback report approach in several ways suited to various audiences and stakeholders throughout Alberta.SignificanceThis study will generate knowledge about the effects of an audit with feedback intervention in home care and supportive living settings. Our dissemination activities will focus on supporting sites to continue to use the Resident Assessment Instrument data in their quality improvement activities.

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Prospects and Pitfalls: Use of the RAI-HC Assessment by the Department of Veterans Affairs for Home Care Clients

Cited by 31 publications

References 32 publications

The impact of sensory impairment on cognitive performance, quality of life, depression, and loneliness in older adults

The impact of sensory impairment on cognitive performance, quality of life, depression, and loneliness in older adults

Case-finding of dementia in general practice and effects of subsequent collaborative care; design of a cluster RCT

Data for improvement and clinical excellence: protocol for an audit with feedback intervention in home care and supportive living

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