Guidelines for Utilizing Assessment Tools | APS-5500-MANUAL

Type of Assessment	Description and Use	Required Use	Recommended Use
APS Risk - Abuse / Neglect / Exploitation Assessment	An assessment tool that is utilized throughout the course of the investigations. It assesses for the presence of abuse, neglect and exploitation and also looks at all six areas of risk (education, housing, medical, social and transportation). It is important to complete all required sections of this assessment in order to get full picture of client’s areas of risk at the time of the investigation. *The Self Sufficiency* and Personal Care sections of this assessment are not required.**	All investigations	N/A
Determination of Need – Revised DON-R	The DON-R evaluates those factors that are the best predictors for need of care. It helps to determine a person’s functional capacity and their unmet need for assistance in dealing with these impairments.	All Investigations	N/A
Saint Louis University Mental Status Exam (SLUMS)	This instrument is used to screen individuals to look for the presence of cognitive deficits. The SLUMS identifies people with more mild cognitive problems that don’t yet rise to the level of dementia. The exam also serves as a tool to indicate whether a doctor should consider further testing to diagnose dementia. It looks at areas of orientation, short-term memory, calculation, naming of animals, clock drawing, and recognition of geometric figures.	All investigations	N/A
Completion and Evaluation of Case Notes	Factual and objective information that the APS staff has seen, heard, touched and/or smelled. This information shall be relative to issues of maltreatment, areas of risk and the acquisition of protective/supportive services. All documents collected by staff and/or completed by staff shall be described in a case note as evidence needed in reaching a case determination and as proof of effort.	In All Cases	N/A
Financial Income Worksheet	The purpose of the APS Financial Income Worksheet is to capture financial information on APS clients (investigation and on-going) that will assist staff to: Determine all income, resources and expenses of the client and his/her household; Identify possible eligibility for Medicaid or other benefit programs Uncover possible areas of suspected financial exploitation Determine if the client is in need of money management services (including rep payee or conservator) Determine of suspected areas of exploitation, neglect and self-neglect are in actuality the result of poverty/lack of resources.	All Financial Exploitation cases	Self-Neglect cases were money management is an issue. Neglect cases were medication, food, clothing, utilities services, and/or personal care services are not being provided.
UAB Financial Capacity Tool	Directed testing tool conducted with individuals who are suspected to lack financial capacity to make reasonable and rational decisions concerning managing his or her money and property. Executive functioning which includes the handling of financial matters is often the first thing to be effected by dimension and other cognitive disorders. The use of a validated and highly sensitive tool such as the distinguish between those	N/A	Prior to seeking involuntary financial intervention: Representative Payee Conservatorship
Falls Risk Assessment Tool	Used to determine what level of risk the client has on falling and how the CM can help to prevent a fall. The test looks at: History of falls # and type of medications Transfer and Gait Balance Sensory loss Continence Mental Status Nutrition Acute illness Chronic medical conditions Home environment	N/A	Individuals with a recent fall or a history of falls. The DON-R has indicated gait/mobility issues. The individual has been diagnosed with Multiple Sclerosis, Parkinson’s or other disorders that can affect gait or mobility. Observation that the individual is not steady or stumbles.
ADRC Risk Assessment for Institutional Placement	Assist the Aging and Disability Resource Center (ADRC) in determining if a client is in need of Options Counseling or Information and Referral (I&R) Services by: asking question that correlate to the top risk factors for nursing home placement; and prioritizing those individuals most at- risk to receive Options Counseling.	Required for all cases where a ADRC referral is being made on behalf of the client. This is done whenever the client has an unmet need (inability to preform ADLs and/or IADLs) and there is no other responsible individual or resource available to assist the adult with meeting such needs.	N/A
PHQ-9	The PHQ-9 screens for depression. The tool looks at the 10 major indexes of depression and rates the frequency of the symptoms which factor into the scoring severity index. Severity is rated on a scale of 0 to 27. Individuals who score in the range of major depressive symptoms they should be strongly encouraged to seek medical advice for diagnostic purposes and possible treatment.	N/A	Individuals who self-identify or have been identified by others as depressed but absent of a true medical diagnosis. Individuals who exhibit symptoms of depression such as: Self-Isolation Trouble sleeping Little energy Changes in appetite Trouble concentrating

Type of Assessment

Description and Use

Required Use

Recommended Use

APS Risk - Abuse / Neglect / Exploitation Assessment

An assessment tool that is utilized throughout the course of the investigations. It assesses for the presence of abuse, neglect and exploitation and also looks at all six areas of risk (education, housing, medical, social and transportation).

It is important to complete all required sections of this assessment in order to get full picture of client’s areas of risk at the time of the investigation.

The Self Sufficiency and Personal Care sections of this assessment are not required.

All investigations

N/A

Determination of Need – Revised

DON-R

The DON-R evaluates those factors that are the best predictors for need of care. It helps to determine a person’s functional capacity and their unmet need for assistance in dealing with these impairments.

All Investigations

N/A

Saint Louis University Mental Status Exam (SLUMS)

This instrument is used to screen individuals to look for the presence of cognitive deficits. The SLUMS identifies people with more mild cognitive problems that don’t yet rise to the level of dementia. The exam also serves as a tool to indicate whether a doctor should consider further testing to diagnose dementia.

It looks at areas of orientation, short-term memory, calculation, naming of animals, clock drawing, and recognition of geometric figures.

All investigations

N/A

Completion and Evaluation of Case Notes

Factual and objective information that the APS staff has seen, heard, touched and/or smelled. This information shall be relative to issues of maltreatment, areas of risk and the acquisition of protective/supportive services.

All documents collected by staff and/or completed by staff shall be described in a case note as evidence needed in reaching a case determination and as proof of effort.

In All Cases

N/A

Financial Income Worksheet

The purpose of the APS Financial Income Worksheet is to capture financial information on APS clients (investigation and on-going) that will assist staff to:

Determine all income, resources and expenses of the client and his/her household;
Identify possible eligibility for Medicaid or other benefit programs
Uncover possible areas of suspected financial exploitation
Determine if the client is in need of money management services (including rep payee or conservator)
Determine of suspected areas of exploitation, neglect and self-neglect are in actuality the result of poverty/lack of resources.

All Financial Exploitation cases

Self-Neglect cases were money management is an issue.

Neglect cases were medication, food, clothing, utilities services, and/or personal care services are not being provided.

UAB Financial Capacity Tool

Directed testing tool conducted with individuals who are suspected to lack financial capacity to make reasonable and rational decisions concerning managing his or her money and property.

Executive functioning which includes the handling of financial matters is often the first thing to be effected by dimension and other cognitive disorders. The use of a validated and highly sensitive tool such as the distinguish between those

N/A

Prior to seeking involuntary financial intervention:

Representative Payee
Conservatorship

Falls Risk Assessment Tool

Used to determine what level of risk the client has on falling and how the CM can help to prevent a fall. The test looks at:

History of falls
# and type of medications
Transfer and Gait
Balance
Sensory loss
Continence
Mental Status
Nutrition
Acute illness
Chronic medical conditions
Home environment

N/A

Individuals with a recent fall or a history of falls.

The DON-R has indicated gait/mobility issues.

The individual has been diagnosed with Multiple Sclerosis, Parkinson’s or other disorders that can affect gait or mobility.

Observation that the individual is not steady or stumbles.

ADRC Risk Assessment for Institutional Placement

Assist the Aging and Disability Resource Center (ADRC) in determining if a client is in need of Options Counseling or Information and Referral (I&R) Services by:

asking question that correlate to the top risk factors for nursing home placement; and
prioritizing those individuals most at- risk to receive Options Counseling.

Required for all cases where a ADRC referral is being made on behalf of the client. This is done whenever the client has an unmet need (inability to preform ADLs and/or IADLs) and there is no other responsible individual or resource available to assist the adult with meeting such needs.

N/A

PHQ-9

The PHQ-9 screens for depression. The tool looks at the 10 major indexes of depression and rates the frequency of the symptoms which factor into the scoring severity index.

Severity is rated on a scale of 0 to 27. Individuals who score in the range of major depressive symptoms they should be strongly encouraged to seek medical advice for diagnostic purposes and possible treatment.

N/A

Individuals who self-identify or have been identified by others as depressed but absent of a true medical diagnosis.

Individuals who exhibit symptoms of depression such as:

Self-Isolation
Trouble sleeping
Little energy
Changes in appetite
Trouble concentrating

These tools shall not be used for diagnostic purposes. When the tools indicated medical or mental health issues the client shall be referred to professional for further evaluation and diagnosis.