Assessment in long-term care

Long-term care has begun to rely heavily on assessment as a basis for deter mining eligibility and payment fur services, as well as for planning needed care. Mandated assessments have been introduced into nursing homes and wil l soon be required for home health care and rehabilitation. Many states use a formal structured assessment process to establish clients' eligibility f or institutional or community-based care. The common feature of such assess ment is attention to physical functioning, but other domains are also relev ant, including affect, social function, cognition, pain and discomfort, and satisfaction. Taken together, this cluster is often referred to as quality of life. While some measures attempt to infer this information from client s' behavior, it is best obtained directly from clients' responses whenever possible. The other major component of a long term care assessment relates to obtaining information on clients' preferences and values. These data are important both for weighting the individual components of an assessment an d for directly addressing preferences about the care and lifestyle availabl e.