Assessing Safe and Independent Living in Vulnerable Older Adults: Perspectives of Professionals Who Conduct Home Assessments

Objectives: The objectives of this study were to describe social services and health professionals' perceptions of vulnerability among older adults living in the community and to elicit how these professionals screen vulnerability in community and in-home settings. Methods: Focus group sessions were conducted and analyzed using standardized methods of qualitative analysis. Participants included social services and health professionals (n = 45) who routinely encounter vulnerable older adults. Results: Four themes characterized vulnerability: the inability to perform activities of daily living, lack of social support, sociodemographic factors, and neuropsychiatric conditions. When screening older adults, participants reported evaluating basic cognitive abilities, decision-making processes, and the capacity to adequately plan and safely perform everyday tasks. Participants stated that screening is best performed by an interdisciplinary team in the home setting and preferably on more than one occasion. Conclusions: Social services and health professionals in this study described routinely screening for vulnerability in community-living older adults using a multidomain approach. These professionals endorse the use of assessments that screen an older adult's cognitive and functional capacities for safe and independent living. Further research is needed that integrates routine screening for vulnerability by community social services professionals with the assessments and interventions conducted by primary care physicians. (J Am Board Fam Med 2010; 23: 614-621.)