General Assessments

KNR 279

General Assessment

Typically CTRS do not administer general assessments but need to be familiar and understand implications of their results for TR services

Sylvester, Voelkl, & Ellis, 2001, p. 304

Lists variety of general assessments (p. 304-308) Physical Psychological Social Quality of life

Stumbo, N. J. (1994/95). Assessment of social skills for therapeutic

recreation intervention. Annual in Therapeutic Recreation, 5, 68-82.

General Assessments

NCTRC/ATRA Global Assessment Functioning (GAF) American Spinal Injury Association Scale (ASIA) Rancho Los Amigos Scale Glasgow Coma Scale Children’s Coma Scale Global Deterioration Scale (GDS)

GAF

Global Assessment of Functioning Scale Behavioral health (psy./substance) Looks at overall functioning Continuum from psychiatric illness to health Looks at highest functioning in last year

GAF (cont.)

Scale 1 (sickest) to 100 (healthiest) 81-90/91-100 = positive mental health 31-70 most outpatients 1-40 most inpatients

Areas Psychological impairment Social skills Dangerousness Occupational skills Substance abuse

GAF (cont.)

Sources: Activity Therapy interview Observation Reliable informant Medical record

Outcome measure Beck Depression Scale, improve from 35 to 18

http://www.bsu.edu/csh/ssrc/media/pdf/gafpage.pdf

American Spinal Injury Association Scale (ASIA)

Used with spinal cord injury Impairment Scale

Complete: No motor or sensory function Incomplete: Sensory but not motor function preserved Incomplete: Motor function is preserved & more than half of

key muscles have muscle grade less than 3 Incomplete: Motor function preserved, grade 4 or more Normal: Motor and sensory function are normal

http://www.sci-info-pages.com/levels.html

Ranchos Los Amigos Cognitive Scale Helpful in assessing patient in first weeks or months

of brain injury Does not require cooperation of patient Based on observations of response to external

stimuli 10 levels (8 levels on original) Scale:

http://www.waiting.com/rancholosamigos.html http://www.braininjury.com/recovery.html

Family guide: http://www.rancho.org/patient_education/bi_cognition.pdf

Glasgow Coma Scale

Assesses degree of brain impairment & identifies seriousness of injury in relation to outcome

3 determinants Eye opening Verbal responses Motor response (movement)

http://www.northeastcenter.com/glasgow_coma_scale.htm

Children’s Coma Scale

Used with children Eye opening Best verbal or nonverbal response Best motor response

http://www.medal.org/visitor/www%5CActive%5Cch17%5Cch17.01%5Cch17.01.02.aspx

Global Deterioration Scale (GDS)

Stages of cognitive function for patients with primary degenerative dementia like Alzheimer’s disease

7 stages 1-3 = pre-dementia 4-7 = dementia stages Beginning in stage 5 an individual can no longer

survive without assistance http://www.seniors-resource.com/frames/

dem9.htm

Global Deterioration Scale (GDS) 1: No cognitive decline 2: Very mild cognitive decline

Age associated memory impairment 3: Mild cognitive decline 4: Moderate cognitive decline

Mild dementia 5: Moderately severe cognitive decline

Moderate dementia 6: Severe cognitive decline

Moderately severe dementia 7: Very severe cognitive decline

Severe dementia

Global Deterioration Scale (GDS)

Brief Cognitive Rating Scale (BCRS) Often used with GDS

Concentration Recent memory Past memory Orientation Functioning & self-care

www.geriatric-resources.com/html/bcrs.html

Assessing Pain

JCAHO requirement January 2001 Importance of pain management

Pain Assessment

Variety of pain assessments http://www.partnersagainstpain.com/

professional-tools/pain-assessment-scales.aspx?id=3

Other Assessment Issues

Language