Assigning service-dependent elderly to appropriate treatment settings

The assignment of service-dependent elderly people to appropriate treatment settings has three phases: assessment of client need; identification of appropriate treatment setting; and placement of the client in that setting. Optimal placement depends upon successfully matching the external and internal treatment setting needs of the client. In analysis of an extended sequence of assignment by the Assessment and Placement Service (APS) of Hamilton-Wentworth (in the Province of Ontario), a highly consistent pre-placement assessment procedure ensured the allocation of a client to an appropriate treatment setting. Staff of the ‘host’ treatment setting overwhelmingly endorsed the placement. There was evidence of minor misjudgements in certain assessment categories, but overall consistency levels were high. A significant minority (14%) of clients were dissatisifed with their placements. General characteristics which influenced client attitude included dislike of being institutionalized, isolation from friends and community, and absence of a rewarding social environment within the treatment setting. The physical setting of, and services offered at, the treatment settings were favourably regarded. The study sample included 33 clients, who were more functionally competent than the general APS population.