Study Examines Assessment Tool for Elderly Adults’ Capacity to Live Independently
Older adults commonly report living safely and independently in their own home as one of their major life goals, and assessing their ability to live independently is an important priority for healthcare professionals. However, this type of assessment is challenging because living independently involves multiple functional domains. For example, deficits in cognitive function can limit one’s ability to implement plans of action related to everyday living, and to execute decisions that maintain one’s safety. Assessing the capacity to make and execute decisions is a central aspect of deciding if an older adult can live independently. An interdisciplinary team of clinicians developed the Capacity Assessment and Intervention (CAI) model to evaluate vulnerable patients – and to assess their capacity for safe and independent living. This article examines the CAI model and highlights common challenges in capacity assessment.
The CAI model consists of a five-step process to guide healthcare professionals through a comprehensive capacity assessment. These steps include: 1) Referral for Assessment (e.g., from social services, healthcare providers); 2) Geriatrics Team Assessment (e.g., physical exam, psych evaluation); 3) Interdisciplinary Team Assessment (e.g., physicians, nurse care manager); 4) Intervention (e.g., family meeting, assisted living placement); and 5) Follow-up (e.g., reassess capacity). The authors note several challenges associated with the CAI model, such as patients who do not share treatment goals with clinicians and family members, which can undermine the intervention process. However, despite some challenges, the authors suggest that the CAI model provides a systematic approach to initiating, conducting, and following through an assessment of an older adult’s capacity to make and execute decisions regarding safe and independent living in the community.
Skelton F, Kunik M, Regev T, and Naik A. Determining if an older adult can make and execute decisions to live safely at home: A capacity assessment and intervention model. Archives of Gerontology and Geriatrics May-June 2010;50(3):300-305.
Drs. Kunik and Naik are part of HSR&D’s Houston Center for Quality of Care and Utilization Studies.