Streamlining outpatient geriatric assessment: essential social, environmental and economic variables

An innovative framework for psychosocial assessment in complex mental capacity evaluations

This study describes an innovative tool developed by the Regional Capacity Assessment Team (RCAT) to assess unique psychosocial factors related to capacity evaluations. Capacity is a socio-legal construct entailing the ability to understand choices, appreciate consequences and follow through (or direct a surrogate) with chosen options. RCAT's targeted psychosocial assessment includes medico-legal factors, social history and supports, coping skills, religious/cultural factors and risk of abuse. RCAT completes the psychosocial assessment to determine whether a full capacity assessment is required (referral disposition) and to determine the impact of an adult's social functioning on their decision-making capacity (capacity determination). RCAT's psychosocial assessment protocol was developed after a comprehensive literature review of capacity assessment and incorporates recommended practices in geriatric social work and psychology. This study will synthesise the pertinent literature, discuss cultural interviewing processes significant to capacity, caregiver assessment and describe the tool itself. Suggestions for future research and appropriate implementation of this tool are provided.

Setting Priorities for Gerontological Social Work Research: A National Delphi Study

PURPOSE

An increasingly important task for all disciplines involved in aging research is to identify and prioritize areas for investigation. This article reports the results of a national Delphi study on setting research priorities for gerontological social work.

DESIGN AND METHODS

Delphi methodology, a structured process for eliciting and correlating informed opinions from a panel of experts on a specific topic, was used. A national expert panel of 46 gerontological social workers completed three successive Web-based questionnaires with controlled feedback to delimit a set of high-priority research topics.

RESULTS

There were 49 independent research topics identified, 16 of which attained high or highest priority and high or moderate consensus ratings. The top-priority topic was developing and testing psychosocial interventions across specific populations and conditions. Three additional topics on intervention research achieved similar ratings, as did all four topics on services research.

IMPLICATIONS

The research priorities identified by expert panelists in this study represent critical knowledge needs for the social work profession in aging, and they overlap and complement the current research agendas of the National Research Council and the National Institute on Aging. They are thus expected to help guide the development and prioritization of social work and interdisciplinary research to improve practice and policies affecting older adults and their families.

The implications of plan design options for Medicare beneficiaries

To make an informed selection between traditional Medicare and a Medicare managed care plan, a consumer needs to understand the implications of choosing one over the other. What are the implications of plan design for care, cost, and patient autonomy? Consumers need information about these questions. However, a barrier to developing this consumer information is the lack of a consistent body of evidence. An intermediate step is to tap expert knowledge. The purpose of this study is to use expert consensus (across a spectrum of health care experts) to identify the implications of plan design. Experts were surveyed and the degree to which there is consensus provides an initial picture of what experts judge to be important to the consumer. The findings show that experts agree on several implications associated with choosing managed care over the traditional Medicare plan. They also agree that many of these attributes vary considerably across health plans.