Understanding the Nursing Assessment: Your Key to a Smooth Elder Care Transition
What is a nursing assessment and why is it required for elder care placement?
When thinking about moving a loved one to an adult family home, an assisted living community, or memory care setting, typically the first item that is needed is a nursing assessment. In fact, Washington state law requires it. The purpose of this evaluation is to identify and understand the health and functional care needs and preferences of the individual seeking placement. This article gives a comprehensive look at the nursing assessment and its critical role in guiding your loved one into the right senior care. I (Nancy) bring over a decade of experience as a Nurse Delegator and provider of long-term care nursing assessments within East King County's adult family homes, offering a unique perspective to help you through this essential process.
Who performs the assessment for adult family homes and assisted living?
Assisted living communities and memory care communities will have their own staff nurse conduct the nursing assessment and will base their monthly fee on the findings. When seeking an adult family home placement, the assessment is performed by a qualified assessor the particular home uses, typically a Registered Nurse (RN). The adult family home provider will give you the name and number of the RN, or better yet, will connect you with the RN via an email or a text so you are in communication with one another to schedule and complete the assessment.
What information is included in a nursing assessment?
The assessment provides a full, unique and personalized picture of the client and his or her care needs, covering the following:
Essential personal details: This includes basic facts like date of birth, insurance information, details for doctors and dentists, and any existing funeral plans, if available.
Key contacts & legal information: Primary contact people with their names, addresses, phone numbers, and email, along with information for the power of attorney (poa) are documented.
Medical history & medications: A thorough list of all medical conditions, current medications, and their dosages is compiled.
Personal preferences & lifestyle: Personal preferences, lifestyle choices, favorite activities, and typical sleep patterns are noted, in addition to specific diet preferred or medically required by the client and favorite foods.
Behavioral & mental health notes: Any diagnoses of depression, anxiety, or dementia are carefully noted, as these require specialized training within adult family homes. Most homes are equipped for this, but screening is always essential.
Detailed system-by-system review: Each body system is reviewed to give providers a complete understanding of all medical issues.
Preliminary plan of care: This vital component outlines exactly how to assist the client with all their needs, ensuring a tailored approach to their care.
How does the nursing assessment support adult family home placement?
The prospective adult family homes that you may be interested in will need to review the assessment to make sure that they can care for the client. If a client is going to need more care than this adult family home can provide, they should decline the client. The RN will identify the client’s deficits and describe how the adult family home can meet the client’s needs.
What documents or details should families prepare ahead of the assessment?
If a client is moving from their home environment into an adult family home, there may not be much in the way of documented information. The RN may ask for the most recent After Visit Summaries from doctor visits, or hospitalizations. However, sometimes family members don’t have them or can’t locate them. In these cases, the RN will ask a lot of questions to put the assessment together.
If a client is in a skilled nursing facility, assisted living/memory care community, or a hospital, the RN will ask for chart material. Typically the power of attorney will grant permission to the facility to share the chart material with the RN, providing a more accurate record than some of the in-home assessments. The RN will go through all the notes, rehab progress, medications, and if there are any wounds, wound progress, and use all of this information in the assessment preparation.
What happens during and after the RN’s on-site visit?
An on-site visit should take about one hour and it is helpful to have one family member present. Having more than one family member can be challenging as conversations begin and this takes valuable time away from the assessment. Most RN’s are very busy and booked up, so getting through all of the questions efficiently is ideal. After the RN has gathered the needed info and visited with the client and a family member, it can take up to 4-6 hours to complete the assessment, depending on its complexity.
After the assessment is completed, I like to have the family member most involved read through the assessment and if corrections, additions or just different facts need to be added or changed, I’ll do that based on the family feedback. Once I make those changes, I’ll send the assessment to the adult family home that the family is interested in, and the adult family home provider will thoroughly review the assessment and determine if they can care for this resident or not.
How much does a nursing assessment cost, and how long is it valid?
A typical fee for an assessment in the King County area is between $400 and $600. The assessment is valid for one year, or must be updated if there are major changes in the client’s condition. If more than 30 days goes by from the time you had the assessment completed until you decide upon an adult family home, the adult family home provider will likely want this assessment updated to a current date. The preliminary plan of care which is included in the initial assessment must be reviewed and finalized within 30 days of residency. When a client settles into an adult family home, routines begin to form between them and the care provider. Sometimes, the initial care plan might need adjustments as these routines develop. That's why we review and update the preliminary plan of care within the first 30 days, ensuring it accurately reflects the client's needs. Once finalized, it's then signed off on. It must be updated annually with the reassessment.
Why is an RN often the best choice to complete a nursing assessment?
While various professionals, including social workers, occupational therapists, physical therapists, ARNPs (advanced registered nurse practitioners), or doctors, can legally complete a nursing assessment, also known as a long-term care assessment, an RN (Registered Nurse) is typically the most qualified and common choice. RNs are uniquely equipped to perform the comprehensive evaluation that’s needed.
Ready to find the perfect adult family home in East King County for your loved one? Contact Calm Harbor Placements today for a no-cost consultation provided by Nancy Haberman, an experienced long-term care RN. Lighting the way to the right senior care starts here.
