Exam 8: The Lived Environment: Community, Housing, and Place

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Decisions about who should or must be admitted to publicly funded long-term-care institutions are difficult. To provide objective assessments of relative need before admission to a facility, to monitor the changes in personal needs, and to assess the quality of care in an institution, most provinces-since the mid-1990s-have adopted a series of what have been termed interRAI assessments (Hirdes et al. 1999b, 2001, 2011; Warren 2000). The interRAI assessment instruments employ standardized methodologies to assess complex populations across home-care, continuing-care, and long-term-care environments (Hirdes et al. 2011). A series of RAIs are used in Canada: the Resident Assessment Instrument (RAI 2.0) for use in long-term-care facilities; the RAI-Home Care Instrument (RAI-HC) for assessing home-care needs; the RAI-Mental Health Assessment; the interRAI Contact Assessment; the interRAI Community Health Assessment; and the interRAI Palliative Care. These instruments have been shown to be highly reliable, valid, and useful in assessing both the needs and the quality of continuing and long-term care (Hirdes et al. 2011; Kehyayan et al. 2015). In some provinces, RAIs are mandated by provincial legislation, whereas other provinces only recommend their use. The application of these standardized assessment tools provides vital information to address the long-term-care issues highlighted above.