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Validity of the Alberta Assessment and Placement Instrument (AAPI) for Use in Admitting Long-Term Care Clients to Home Care*

Published online by Cambridge University Press:  29 November 2010

Lili Liu  and
Linda Lazaruk
Lili Liu
Affiliation:
University of Alberta
Linda Lazaruk
Affiliation:
Capital Health Authority Home Care Program, Edmonton
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Abstract

The Alberta Assessment and Placement Instrument (AAPI), a multidimensionalassessment, is used to assess clients for continuing care in Alberta. We conducted a retrospective chart review to determine the validity of the AAPI items for use with long-term clients who are referred to Home Care. We were also interested in determining the status of clients one year after they were admitted to home care. The charts of 60 clients admitted to home care and 60 not admitted were randomly selected for the year 1992, the most recent year during which a duplication of all AAPI results was kept. The groups did not differ in demographic characteristics, measures of perceived need, number of medications, nutrition, cognitive status, psychosocial status, and use of formal and informal care providers as described in the AAPI. However, they differed significantly in medication management: those admitted to home care required more assistance with medication management than those not admitted. Therefore, use of the AAPI alone does not determine whether or not a client is admitted to home care. When the charts were followed one year after the initial administration of the AAPI, only 18 per cent of those admitted to home care remained on home care whereas 42 per cent of those not admitted to home care were now admitted. The admission of a client to home care was associated with an increased likelihood of being admitted to a long-term care institution (OR = 6.56) or being deceased (OR = 5.36) one year later.

Résumé

L'instrument d'évaluation multidimensionnelle Alberta Assessment and Placement Instrument (AAPI) sert à évaluer la clientèle des soins prolongés en Alberta. Nous avons réalisé un examen rétrospectif des fiches afin de déterminer la validité des éléments de l'AAPI utilisés avec des clients à long terme qui sont dirigés vers les soins à domicile. Nous voulions déterminer aussi l'état des clients un an après avoir été admis aux soins à domicile. On a choisi au hasard, pour l'année 1992 (l'année la plus récente au cours de laquelle une copie de tous les résultats de l'AAPI a été conservée), les fiches de 60 clients admis à des soins à domicile et de 60 clients non admis à ces soins. Les groupes ne différaient pas quant aux caractéristiques démographiques, aux mesures de besoins perçus, au nombre de médicaments, à la nutrition, à l'état cognitif, à l'état psychosocial, et à l'utilisation de dispensateurs de soins formels et informels, comme cela est expliqué dans l'AAPI. Cependant, ces groupes différaient considérablement quant à la gestion de la médication: les personnes qui ont été admises aux soins à domicile nécessitaient plus d'aide quant à la gestion des médicaments que les personnes non admises. Par conséquent, l'utilisation de l'AAPI à lui seul ne détermine pas si un client ou une cliente est admis(e) aux soins à domicile. Quand on a fait le suivi des fiches un an après le début de l'administration de l'AAPI, seulement 18 pour cent des personnes admises aux soins à domicile se trouvaient toujours aux soins àdomicile, tandis que 42 pour cent des personnes non admises aux soins à domicile l'étaient à ce moment-là. L'admission d'un client ou d'une cliente aux soins àdomicile était associée à une probabilité accrue d'être admis(e) à un etablissementde soins prolongés (OR = 6,56) ou d'être décédé(e) (OR = 5,36) après un an.

Keywords

Placement InstrumentLong-Term CarePlacement DecisionsValidityInstrument de placementsoins de longue duréedécisions de placementvalidité
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 17 , Issue 3 , Automne/Fall 1998 , pp. 296 - 310
Copyright
Copyright © Canadian Association on Gerontology 1998

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