Lesson 5: Interviewing and Assessment

Attention

Assessment is key to understanding the factors that are involved in the situation...which is what you need to know to come to solutions. We have "instincts" for what might be going on in a persons' life, but we need "evidence" before we act!

Learning Outcomes

Upon completion of this lesson's material, students will be able to:

• Conduct a mini-mental health status assessment
• Identify legal and ethical considerations when interviewing an elderly client
• List major areas of consideration when establishing an alliance with an elderly client

Teaching

Read Chapters 3 and 4 in Cohen & Eisdorfer

Comprehensive Assessment

Chapter 3 outlines the major types of assessments that are performed when an older person is being brought in for services. This is geared toward intake professionals, nurses, doctors, etc. As you can tell, this type of assessment is very comprehensive and might even take time to complete.

For the purpose of this course we are going to examine two types of assessments: A comprehensive admission assessment for a long-term care facility and a brief mental status exam.

Interviewing

Chapter 4 focuses on the factors involved in developing a relationship with your client. This material applies to nearly everyone in the field.

Ethical Issues

• Consent
• Confidentiality
• Autonomy
• Beneficence and Nonmaleficence
• Fidelity (continuity of care)

How doe the following issues pertain and impact the ethical issues?

• Presence and involvement of family members?
• POAs
• Cognitive ability?

Interviewing

• Individual culture and beliefs
• History
• Communication styles
• Respect, compassion, interest, and support
• Non verbal behaviors
• Eye contact
• Sensory and cognitive impairments

Emotional Development

• Emotional well-being (losses and gains)
• The "Ageless Self"
• Identity Crisis

As people deal with their changed bodies and abilities, and the consequences of such, they have to redefine themselves. Consider the individual with a very rigid sense of "independence". This is much more than a health crisis, it is an identity crisis.

Establishing a Relationship

• Issues related to transference and counter transference
  • How do you relate to elderly people in your own life?
  • What if they remind you of relatives?
  • What if you YOU remind THEM of relatives?
• Trust
  • How do you establish a sense of trust between you and your client in order to get their "story"?

Assessment in the "Real World"

• I managed to get copies of a few of the assessments that are conducted on a regular basis at a local nursing home
• Review the following and consider how you might approach asking these types of questions:
  • Nursing Assessment
  • Social Service Assessment
  • Social Service Interview
  • Montreal Cognitive Assessment A and Montreal Cognitive Assessment B (there are two versions of this particular assessment in order to allow test and re-test applications)

Assessment

Possible Class Discussion / Activity

Using either the Social Service Interview or either one of the Montreal Cognitive Assessment documents above, interview a person in your life. Report your findings and reflect on how useful you feel a test like this is to administer. Reflect on how comfortable you were asking some of the questions.

Lesson 5 Quiz

1. How do you relate to elderly people in your own life?
2. How might a client who is similar to a relative impact your interactions with them?
3. How might you react to a client who treats you like a child of theirs?
4. List some important factors related to establishing a trusting relationship with your elderly client. (Use the textbook as references)