Tool appropriate to all types of disability Yes Yes but some question as to reliability of mental health measures Yes Yes but edited version needed for people without an ID Tool’s most tested domain Mental health Eldercare n/a ID Internal reliability (consistency between a person’s ratings on related items of the tool) Yes. Not peer reviewed Yes No evidence Yes Inter-rater reliability (consistency between administrators’ ratings of the same person) Yes. Not peer reviewed Yes No evidence found Yes Test-retest reliability (consistency between a person’s ratings over two or more different time periods) Yes. Not peer reviewed Yes No evidence found Yes Content validity (degree to which professionals agree that the full construct (support need) is measured by the tool) Yes for mental health Yes No evidence found Yes validity (consistency between a person’s rating on the tool and similar measures or clinical judgement of professionals) Yes for mental health Yes No evidence found Yes To summarise, comparing the technical characteristics of the tools is difficult because the tools are not tested to the same extent, on the same domains or using the same tests. FACE has not published peer review evaluations, however internal FACE papers do show good statistical properties. InterRAI has the most testing, particularly for eldercare and this shows good reliability, validity and consistency. SIS has published evaluations for its intellectual disability tool that has good statistical properties. We could find no published statistical tests for RAS 5.
researchers) are generally granted a royalty-free license” (emphasis added ). The royalty-free licence comes with some clauses (the following comes from the interRAI website): the instrument is not to be changed substantially (excepting individual identifiers and demographics), although additional items can be added only licensed translations can be used the instrument will not be incorporated into products to be sold to or paid for by others the organization will make appropriate efforts to inform others of the copyright status of the instrument interRAI's logo and copyright notice are to appear on the form and any other publication authors, author institutions, and translators (as appropriate) are to be acknowledged in any document where authors would usually be listed electronic data from use of the instrument are to be shared with interRAI, subject to existing laws on confidentiality and data use. A report written for the U.S. Department of Health and Human Services highlights “IP issues with respect to the RAI/MDS are complicated because the assessment instrument and data set have always been considered to be in the public domain, but only in the United States. Beyond United States borders, interRAI claims rights to version 2.0 of the RAI and MDS, and use of the RAI/MDS requires a license agreement with interRAI. IP issues are further complicated by the fact that the 1995 edition of the user's manual for version 2.0, written for and with HCFA, has been copyrighted by interRAI with the U.S. Copyright Office, which is unusual for a work considered to be in the public domain” p11. The other instruments for assessing people across the continuum of care, for example home care, assisted living, palliative care, and acute care, appear to be solely the intellectual property of interRAI, and their use subject to licensing agreements with interRAI. InterRAI has promoted the complete set of assessment instruments as suitable for assessing all post acute care patients. The report highlights an issue about the intellectual property of scales based on the interRAI. Copyright information on the interRAI web site includes the statement: "The scales, algorithms, and case-mix measures based on these assessment instruments cannot be copyrighted and are thus available to everyone (although the individual items on which they are based are usually copyrighted).” The report argues that
of emotional wellbeing – Based on typical week Mood Emotional well-being Worsening psychological condition Anxiety Contact with Mental Health Services Contact with formal care providers Routine screening/ Vaccinations Disease diagnosis Health General well being General health No, some, extensive support needed Worsening physical condition Physical health Exceptional, Medical and Behavioural support needs Balance status Recent observation screening, tests or investigations Service utilization/ Treatments & procedures Breathing Dyspnea (shortness of breath) Respiratory care(inhalation or oxygen therapy, postural drainage/chest PT/suctioning) Fatigue symptoms (shakes, spasms etc) Falling/recent Falls Pain Pain Continence Incontinence Pressure sores/wounds and Other skin conditions Pressure ulcers and other skin problems Skin care Foot Health Foot problems
Currently taking Medication and problems with medication (side effects): details of types/ problems taking medication/using health aids/risk of medicine mismanagement List of all medications Health risks (severe medical health risks) Lapses of consciousness Other exceptional medical care Oral health Dental /oral health Tube feeding Allergies Drug allergies Sleep Sleep problems Nutrition eating/drinking How eats and drinks Eating food/ Parenteral feeding Diet/ Nutrition Chewing problems Maintain a nutritious diet Swallowing Swallowing problems Maintaining Nutritious diet Mode of Nutritional intake (pureed, tube etc) Oral stimulation or jaw positioning Substance use/ smokes Caffeine, alcohol, tobacco use Substance abuse Regular exercise How many of exercise Weight Nutritional issues (weight loss weight gain Behaviour supports needed Behaviour affecting self and others/harm to relationships/isolation Harm to self and others No, some, extensive support needed Mood and behaviour Emotional outbursts or tantrums
Locomotion - method and capacity to move around home moving around the home Stairs (capacity on 8 pt scale) Ambulating and moving about mobility aids transfers getting out and about Accessing public buildings and settings Self-care - health etc taking medication, difficulty Medication adherence Taking medications Difficulty obtaining access to medication Obtaining health care services Difficulty self-managing medication Learning how to access emergency services Difficulty taking medication as prescribed Maintaining physical health and fitness Staying occupied keeping appointments Public services in the community Household tasks Capacity and performance - 8pt scale Needs help in the practical aspects of daily living help with household tasks preparing main meal/ preparing drinks/snacks Cooking Preparing food housework Housework (inc laundry) Housekeeping Operating household appliances Clothes and Laundering Shopping and money household shopping Shopping Shopping and purchasing goods and services
Change in mental functioning Community living activities Social participation and inclusion Accessing community services (shops or library etc) Participating in in community settings Needs in regards social activities and relationships Engaging with neighbours Visiting friends and family Sense of involvement Participating in community groups Community activities (church, voluntary groups) Interacting with community members Socialising within / outside household Being with friends Making and keeping friends Social activities and relationships Sexual activity and social inclusion Engaging in loving and intimate relationships Structured activity (formal education, day programme, volunteering) Engaging in volunteer work Number of days participating in preferred leisure programme Work/ education/ training Employment status Participating in decisions
Requires support for in Work, learning & leisure Learning and using job skills Completing work-related tasks with acceptable quality Accessing job Employment arrangements (competitive or supported employment) Seeking information or assistance form employer Changing job assignment Completing work tasks to standard Performance and capacity to work (rated on 8 point scale) Interacting with / supervisors Interacting with others in learning environments Learning and using problem solving Using technology for learning Accessing training settings Learning functional skills