Professional's and older person's assessments of functional ability, health complaints and received care and service....

The aim of the study was to investigate the level of agreement between the needs assessment made by professional on the one hand, and the older person's views on the other. A further aim was to explore if the estimations made by the professional were systematically lower or higher compared to the views of the older person.

The study included 152 individuals, 65+, who received public care and services in southern Sweden. The concept public care and services include home help, home nursing care, rehabilitation and special accommodation.

Standardised needs assessments were performed by home help officers, registered nurses and one physiotherapist. Subsequently to the needs assessment, the older person's view was collected in a personal interview. Standardised assessment form was used covering items about demographic data, functional ability, health complaints, adaptation in housing, public and informal care. The concept informal care includes care from spouse and children. Cohen's Kappa was used for analysis of level of agreement and Chi-square tests for differences in estimation.

Level of agreement for dependency in instrumental activities of daily living (IADL) and personal activities of daily living (PADL) varied between good (kappa=0.78) and moderate (kappa=0.43). Poor agreement was found for occurrence of dizziness (kappa(w)=0.17) and fair agreement for impaired hearing (kappa(w)=0.27), urinary incontinence (kappa(w)=0.38), pain (kappa(w)=0.21), anxiety (kappa(w)=0.37) and depressed mood (kappa(w)=0.37). Older persons reported more health complaints than in the professional's assessments, significantly lower estimation was found for incontinence and vision. Level of agreement for provided public care at home (home help and home nursing care) was poor, for informal care it varied between very good and moderate.

Needs assessments appeared to focus on older persons ADL, cognition and informal care, while health complaints and social needs were less in focus. A more comprehensive view including preventive and palliative approach may improve quality of life for older persons receiving care and service.