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General Assessments. KNR 279. General Assessment. Typically CTRS do not administer general assessments but need to be familiar and understand implications of their results for TR services Sylvester, Voelkl, & Ellis, 2001, p. 304 Lists variety of general assessments (p. 304-308) Physical
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General Assessments KNR 279
General Assessment • Typically CTRS do not administer general assessments but need to be familiar and understand implications of their results for TR services • Sylvester, Voelkl, & Ellis, 2001, p. 304 • Lists variety of general assessments (p. 304-308) • Physical • Psychological • Social • Quality of life • Stumbo, N. J. (1994/95). Assessment of social skills for therapeutic recreation intervention. Annual in Therapeutic Recreation, 5, 68-82.
General Assessments • NCTRC/ATRA • Global Assessment Functioning (GAF) • American Spinal Injury Association Scale (ASIA) • Rancho Los Amigos Scale • Glasgow Coma Scale • Children’s Coma Scale • Global Deterioration Scale (GDS)
GAF • Global Assessment of Functioning Scale • Behavioral health (psy./substance) • Looks at overall functioning • Continuum from psychiatric illness to health • Looks at highest functioning in last year
GAF (cont.) • Scale 1 (sickest) to 100 (healthiest) • 81-90/91-100 = positive mental health • 31-70 most outpatients • 1-40 most inpatients • Areas • Psychological impairment • Social skills • Dangerousness • Occupational skills • Substance abuse
GAF (cont.) • Sources: • Activity Therapy interview • Observation • Reliable informant • Medical record • Outcome measure • Beck Depression Scale, improve from 35 to 18 • http://www.bsu.edu/csh/ssrc/media/pdf/gafpage.pdf
American Spinal Injury Association Scale (ASIA) • Used with spinal cord injury • Impairment Scale • Complete: No motor or sensory function • Incomplete: Sensory but not motor function preserved • Incomplete: Motor function is preserved & more than half of key muscles have muscle grade less than 3 • Incomplete: Motor function preserved, grade 4 or more • Normal: Motor and sensory function are normal • http://www.sci-info-pages.com/levels.html
Ranchos Los Amigos Cognitive Scale • Helpful in assessing patient in first weeks or months of brain injury • Does not require cooperation of patient • Based on observations of response to external stimuli • 10 levels (8 levels on original) • Scale: http://www.waiting.com/rancholosamigos.html http://www.braininjury.com/recovery.html • Family guide: http://www.rancho.org/patient_education/bi_cognition.pdf
Glasgow Coma Scale • Assesses degree of brain impairment & identifies seriousness of injury in relation to outcome • 3 determinants • Eye opening • Verbal responses • Motor response (movement) • http://www.northeastcenter.com/glasgow_coma_scale.htm
Children’s Coma Scale • Used with children • Eye opening • Best verbal or nonverbal response • Best motor response • http://www.medal.org/visitor/www%5CActive%5Cch17%5Cch17.01%5Cch17.01.02.aspx
Global Deterioration Scale (GDS) • Stages of cognitive function for patients with primary degenerative dementia like Alzheimer’s disease • 7 stages • 1-3 = pre-dementia • 4-7 = dementia stages • Beginning in stage 5 an individual can no longer survive without assistance • http://www.seniors-resource.com/frames/dem9.htm
Global Deterioration Scale (GDS) • 1: No cognitive decline • 2: Very mild cognitive decline • Age associated memory impairment • 3: Mild cognitive decline • 4: Moderate cognitive decline • Mild dementia • 5: Moderately severe cognitive decline • Moderate dementia • 6: Severe cognitive decline • Moderately severe dementia • 7: Very severe cognitive decline • Severe dementia
Global Deterioration Scale (GDS) • Brief Cognitive Rating Scale (BCRS) • Often used with GDS • Concentration • Recent memory • Past memory • Orientation • Functioning & self-care • www.geriatric-resources.com/html/bcrs.html
Assessing Pain • JCAHO requirement • January 2001 • Importance of pain management
Pain Assessment • Variety of pain assessments • http://www.partnersagainstpain.com/professional-tools/pain-assessment-scales.aspx?id=3
Other Assessment Issues • Language