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Making and Executing Decisions for Safe and Independent Living (MED-SAIL): development and validation of a brief
Whitney L Mills1, Tziona Regev2, Mark E Kunik3
1Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX.
Objectives:
Older adults prefer to remain in their own homes for as long as possible. The purpose of this article is to describe the development and preliminary validation of Making and Executing Decisions for Safe and Independent Living (MED-SAIL), a brief screening tool for capacity to live safely and independently in the community.
Design:
Prospective preliminary validation study.
Setting:
Outpatient geriatrics clinic located in a community-based hospital.
Participants:
Forty-nine community-dwelling older adults referred to the clinic for a comprehensive capacity assessment.
Measurements:
We examined internal consistency, criterion-based validity, concurrent validity, and accuracy of classification for MED-SAIL.
Results:
The items included in MED-SAIL demonstrated internal consistency (5 items; α = 0.85). MED-SAIL was significantly correlated with the Independent Living Scales (r = 0.573, p ≤0.001) and instrumental activities of daily living (r = 0.440, p ≤0.01). The Mann-Whitney U test revealed significant differences between the no capacity and partial/full capacity classifications on MED-SAIL (U(48) = 60.5, Z = -0.38, p <0.0001). The area under the curve was 0.864 (95% confidence interval: 0.84-0.99).
Conclusions:
This study demonstrated the validity of MED-SAIL as a brief screening tool to identify older adults with impaired capacity for remaining safe and independent in their current living environment. MED-SAIL is useful tool for health and social service providers in the community for the purpose of referral for definitive capacity evaluation.
