Assessing the mental health needs of older people
The assessment process
Assessing the mental health needs of older people requires the same skills as any other assessment, and is based on the same principles of a person-centred approach and the individual's right to high standards of assessment and services. People with mental health needs may be more vulnerable, more anxious, more confused, and perhaps have a history of being dismissed as mentally ill. You can help by adopting the same approach as you would to anyone else, by being open, honest, respectful and empathetic.
For a more detailed account, see Research Summary 3 (453kb PDF).
- Older people being assessed are likely to experience some anxiety, particularly if they believe the assessor is looking for signs of cognitive impairment.
- There is a tendency for older people's needs to be defined by professionals rather than by the older people themselves.
- Older people don't necessarily value the same aspects of an assessment as professionals.
- There are some advantages in using standardised measures.
- It is important to try to understand the older person in the context of their world.
- The most important factor is for assessors to
develop good communication skills:
- using down-to-earth, everyday language, avoiding jargon
- being a good listener, able to identify underlying meanings
- using prompts, such as photographs
- allowing the person to take the lead in conversation rather than using direct questioning
- taking time to build a relationship with the person being assessed.
- Don't panic. Assessing older people with mental health needs requires the same skills as any other assessment, and is based on the same principles.
- Don't make assumptions. Be open to other possibilities.
- Address the basics. Is the person physically ill? Can they see, hear, understand you? Do they know who you are and what the assessment is for? What effect is the environment having?
- Slow down. Take time to build up trust. Build up a rapport over several visits. At each visit, remind the person who you are and what you talked about last time. Take time to talk around the situation - be unhurried. Do not try to move the person on faster than they can cope with.
- Explain carefully, using simple, everyday language. Avoid jargon.
- Find out about the person's life, and use prompts, e.g. photos, to get the person talking. Use family members and others who know the person to fill in the gaps.
- Let the person take the lead. Be careful not to guide what the older person is saying.
- Listen carefully for underlying meanings; be alert to non-verbal communication such as facial expressions, body language.
- Assume the person has mental capacity, particularly when considering and assessing risks, unless and until there is evidence to the contrary.
- Involve others - family members, advocates, other professionals.