Strategies for Assessing and Monitoring Appropriate Long Term Care for Elderly People

Abstract

Assessment (particularly) and monitoring are current “buzzwords” amongst geriatric policy-making groups in relation to long term care. However, developing assessment instruments which are appropriate for both clinical level decision-making and programme level planning is no easy task. Because of the different purposes for which they are intended, an all-purpose instrument can rarely be produced. Nevertheless, whatever criteria are adopted at the programme planning level should, at the very least, bear some resemblance to the way clinical-level decisions are made. This observation is somewhat obvious, yet by no means standard practice. Planning norms of the kind - 10 geriatric beds per thousand elderly population, bear little, if any, relationship to the way clinical-level decisions are made; nor, as single statements, do they recognise the inter-relationship of alternative appropriate long term care options. This paper considers two approaches towards planning which attempt to take account of the problems identified above, and which demonstrate the inter-connection of grass roots data bases from individual patient assessments and the more general requirements for strategic planning.