Strategies Used by Home Health Nurses to Assess the Mental Status of Homebound Elders

Home health nursing practice requires the ability to accurately assess elderly clients and, based on this assessment, arrange for needed home care services. Accurate evaluation of a homebound elder's mental status is particularly important, for it indicates whether the individual will be able to survive in his or her home and thereby avoid institutionalization. However, previous studies suggest that nurses in a variety of settings use assessment criteria that result in inaccurate judgements about their client's cognitive status. This study was undertaken to investigate specific strategies used by home health nurses to determine mental status. A convenience sample of 84 home health nurses was surveyed about the assessment criteria they used in their practice. Findings showed that these nurses, like others, rely primarily on orientation to evaluate cognition.