New instrument can assess assisted living residents' ADL skills

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Mary Bowen, Ph.D.
Mary Bowen, Ph.D.

Healthcare professionals and researchers who work in assisted living settings may have another instrument to assess residents' physical and cognitive skills if the early results of a recent study hold up in future research.

The performance-based instrument, called the Physical and Cognitive Performance Test for Residents in Assisted Living Facilities, or PCPT ALF, was tested in a 116-bed assisted living facility and appeared to be a valid and reliable way to determine the success of interventions designed to prevent or slow the decline of residents' performance of activities of daily living and instrumental activities of daily living, according to researchers.

The test can be given however often deemed necessary to assess an intervention.

Specifically designed for the assisted living environment, the test aims to determine what residents can do physically versus what they understand they should do. The separation between physical ability and cognitive ability will help professionals create more effective interventions, Mary Bowen, Ph.D.,principal investigator of the study and an assistant professor at the University of Delaware School of Nursing, told McKnight's Senior Living.

This tool helps a clinician or researcher establish a baseline, watching for changes over time and developing tailored interventions," said Bowen. "It is useful for intervention development.” 

Although previous tests had been designed to measure similar markers, Bowen said they often needed to be administered by someone who had long-term knowledge of the resident being tested. This requirement was not practical for measuring the effectiveness of interventions in assisted living, she added, because it is a long process for a test administrator to be able to determine the effectiveness of an intervention at a specific moment in time.

Further, Bowen said, previous tests were not always suitable for residents in assisted living environments because they have varying levels of independence. For example, she said, a test administrator may need to know whether residents can bathe themselves, but observing this task could be especially intrusive for residents with significant independence.  

"While there are valid and reliable tools to assess functioning, these tools were not developed for this population and setting. It is a unique environment with a range of residents - from semi-independent to dependent." 

To develop the instrument and determine its effectiveness, the study had three phases. First, the instrument items were developed and tested for validity. Next came a feasibility pilot study with 10 residents and, finally, a cross-sectional trial with 55 additional residents to establish construct and criterion validity and reliability. The research appeared in the Journal of the American Geriatrics Society.

Future research will look at how the test holds up in other environments, Bowen said.

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