Examining the ability of the interRAI communication collaborative action plan to identify individuals with sensory challenges: A retrospective cohort study

Background

The current study evaluated the performance of the interRAI communication collaborative action plan (CAP) to flag individuals with sensory impairments who could benefit from intervention. Investigators also examined how the CAP can help facilitate client-centered care planning and service delivery by exploring three unique case studies.

Method

This retrospective cohort study utilized secondary data collected using the Resident Assessment Instrument for Home Care (RAI-HC) across Canada. The sample included individuals aged 65 years or older who had two RAI-HC assessments completed between 2008 and 2020 (n=508,856). At time 1, individuals were categorized into three mutually exclusive groups based on their CAP triggering level: not triggered, triggered to facilitate improvement, or triggered to prevent decline. The three groups were compared across demographic characteristics, sensory impairments, cognitive challenges, and disease diagnoses. Transitions between triggering levels from time 1 and time 2 were analyzed using Sankey diagrams. Three case studies were examined to identify the reasons why someone may no longer trigger on the CAP at time 2.

Results

The median time between an individual’s intake and most recent assessment was 21 months (standard deviation=24.7 months). The majority of individuals did not trigger on the CAP at time 1 (77.7 %; n=395,309), while 9.5 % (n=48,263) triggered to facilitate improvement and 12.5 % (n=65,284) triggered to prevent decline. For each of the sensory impairments, the majority of individuals were more likely to fall into the triggered to facilitate improvement group.

Conclusions

The communication CAP was robust in flagging individuals with sensory impairments as these individuals are more likely to fall into the triggered to facilitate improvement group. The three case studies highlight the importance of assessing all aspects of communication (e.g., cognitive, and sensory challenges, receptive and expressive communication), as they are all necessary components when considering decision-support tools and next steps.