Overview of a Needs Assessment Before Moving to Assisted Living

In advance of moving to assisted living, a prospective resident should undergo what is known as a thorough needs assessment. A needs assessment evaluates a prospective resident’s overall physical and cognitive health. A needs assessment can include information from that individual’s primary care physician and other healthcare resources. It also should include an in-person assessment of the prospective resident as well. The in-person assessment is typically undertaken by a nurse or other experienced, qualified member of an assisted living community’s admissions team.

The needs assessment is designed to ascertain a prospective resident’s level of care. It is designed to assist in creating a new resident’s care plan. There are several categories included in a need assessment that includes:

  • Gauging prospective resident orientation
  • Level of bathroom assistance
  • Fall history and fall risk
  • Level of mobility

Gauging Prospective Resident Orientation

Some factors are considered when it comes to a prospective resident’s orientation. These include:

  • Is oriented to and aware of people, places, and time.
  • Has occasional confusion and some difficulty recalling details. Needs some prompting.
  • Requires regular prompting due to confusion and disorientation.
  • Has severe cognitive deficits and a history of poor judgment, creating potentially unsafe behaviors.

Level of Bathroom Assistance

Several factors regarding the level of bathroom assistance a prospective resident might need in an assisted living community are examined. These include:

  • Is a continent of bowel and bladder and manages to toilet independently
  • Is continent of bowel and bladder and independently manages protective and/or assistive devices
  • Requires occasional reminders/prompting to go to the bathroom
  • Has intermittent episodes of incontinence
  • Requires reminders for protective garment use
  • Requires assistance to manage bowel or bladder
  • Requires a two-person lift or assist when toileting

Fall History and Fall Risk

Falls are the number one cause of injury to women and men in their senior years. As part of a needs assessment, attention is paid to a prospective resident’s fall history and fall risk. The fall history and fall risk assessment includes a consideration of the following:

  • Has never fallen
  • Has one fall in the last three months
  • Has more than one fall in the last three months

Level of Mobility

An assisted living needs assessment includes a consideration of the level of mobility of a woman or man seeking admission into an assisted living community. The factors considered associated with the level of mobility include:

  • Is independent in mobility
  • Requires reminders to use assistive devices
  • Requires the assistance of one person for transfers
  • Requires assistance to push a wheelchair due to a physical limitation
  • Requires a two-person assist or lift for transfers

Other Activities of Daily Living

A needs assessment also examines a prospective resident’s ability to undertake other activities of daily living. These include a consideration of other activities of daily living that include (but are not necessarily limited to):

  • Need for assistance with housekeeping
  • Need for assistance with laundry
  • Need for assistance with meal preparation
  • Need for transportation assistance

Medication Management

Many people elect to move to assisted living because they need some level of assistance with medication management. Through this element of a needs assessment, it must be confirmed that a prospective resident can self-administer any medications. A determination must be made that a prospective client’s medication management needs can be met within the parameters permitted by state statue and regulations.

Diet and Nutrition

A needs assessment must also evaluate a prospective resident’s diet. If a special diet is needed (like a diabetic diet), a determination must be made that such a specialized diet can be prepared and provided at a specific assisted living community.

Caregiver Role in Needs Assessment

If a senior seeking admission into assisted living has a family caregiver or even a professional one, that individual has a role to play in the needs assessment. In many ways, a caregiver will have the most relevant and usually current information about the needs and abilities of a prospective assisted living community resident.

Ongoing Needs Assessment and Care Plan Review

After a senior takes up residency in an assisted living community, needs assessments need to occur in the future. Care plans are reviewed and revised as necessary in conjunction with ongoing needs assessments.

Many states have regulations set forth a specific time frame for a subsequent or recurring needs assessment. Absent a specific regulation setting forth when a subsequent needs assessment should occur. There is a consensus in the assisted living industry that a needs assessment and reconsideration of a care plan must occur annually. These subsequent assessments should occur even if a resident does not show obvious physical or cognitive decline.