ABC’s of OT: my favorite ASSESSMENTS to use in the SNF

When it comes to evaluating patients, no matter what setting you’re in, standardized assessments are essential in painting a full picture of your patient’s current medical and functional status. Every occupational therapist in every setting should ultimately be using at least one standardized assessment in their therapeutic evaluations.

It is important to remember that not all available assessments are standardized.

A standardized assessment is one that has been tested in a controlled setting where age-related norms can be identified and established, while the reliability and validity of the assessment can be determined. Therefore, standardized assessments are {obviously} more reliable than those that are not standardized.  If an assessment is standardized, you will be able to find all of the information about its reliability and validity in the assessment’s manual.

There are a few assessments that I always use with every single patient that I evaluate in the SNF setting.

Manual Muscle Testing – This is one of the first assessment techniques we learn in OT school and it is a simple yet effective way to assess a patient’s strength at evaluation and throughout the course of therapy. You can find my quick reference guide for manual muscle testing here.

Dynamometer – Grip strength is necessary for safety when using grab bars, walkers, or mechanical lifts for functional transfers and mobility as well as for completing basic ADL and IADL tasks. So a quick grip test with the dynamometer is easy and important to incorporate into the initial eval and the subsequent progress notes.

Montreal Cognitive Assessment – Otherwise known as the MOCA, this assessment is a quick, one-page overview of a patient’s cognitive abilities including executive functioning, attention, language, orientation, and short-term memory/recall. You can find all the info about this assessment here.

Then there are other assessments that I only use if I feel they are indicated based on my formal clinical assessment.

Allen’s Cognitive Levels – The ACL was designed by Claudia Allen to formally understand a patient’s ability to follow directions and problem solve through the use of a leather lacing tool. The scores are then broken down into basic hypothesized cognitive abilities that can be used to grade therapeutic interventions and educate the patient and staff members on the best means of care. OT Miri has an amazing video that breaks down these levels. You can find all the information about the assessment here.

Leisure Checklist – There are a variety of leisure checklists available to easily and quickly assess what activities are most meaningful for a patient. Information from these checklists can be used to better engage patients into treatment sessions. You can find an example of a leisure checklist here.

Geriatric Depression Scale – Depression can be incredibly prevalent in the geriatric population. Sometimes patients are not always aware of how to articulate when/if they are feeling saddened or depressed. The questions on this scale help to appropriately cue insight into self. The score can then be used to justify an evaluation to the facility’s psychiatric services. You can find the Geriatric Depression Scale here.

Motor-Free Visual Perception Test – Dementia can greatly affect a patient’s visual-perceptual abilities which can in-turn result in poor safety during all functional transfers and mobility. The MVPT is a great way to formally assess what specific areas of visual-perception are affected, and all the information about this assessment can be found here.

 

What are some of your go-to assessments when completing your therapeutic evaluations?

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