Multidimensional Functional Assessment of Older Adults

The Duke Older Americans Resources and Services Procedures

Gerda G. Fillenbaum

• Publisher: Psychology Press
• Year: 2013
• Topic: Psychology
• eBook ISBN:
  9781134741939
• Subtopic: Developmental Psychology
• Index: Psychology

Reliable, easily administered, and objective ways of assessing the well-being of the elderly and their use of, and need for, services are rare. The author of this study provides current information on the Multidimensional Functional Assessment of Older Adults (MFAQ) -- the most widely used questionnaire of its type. This volume discusses ways in which the procedure has been used and can be used by clinicians, program evaluators and planners.

The book also examines OARS (Older Americans Resources and Services Program) MFAQ and how it permits assessment of the level of functioning in five areas: social, economic, mental health, physical health and self-care. Readers will find detailed and updated information on administration, hand and computer-based scoring, as well as use of the questionnaire.

	1
The OARS Multidimensional Functional Assessment Questionnaire

Chapter Overview

The OARS Multidimensional Functional Assessment Questionnaire has two parts. Part A focuses on assessment of functional status, Part B on services assessment. In addition, a section covering administrative and demographic information is included. The questionnaire is so arranged that information can be obtained from three sources: the subject, an informant, and the interviewer. This chapter provides details regarding the number of items included in each area, the conceptualization underlying their selection, and item origin.

The OMFAQ is a structured questionnaire designed to obtain information on functional status (Part A), service use (Part B), and on administrative and demographic matters. Information can be obtained from each of three sources: the respondent, an informant, and the interviewer. Information is typically obtained in face-to-face interviews. These take an average of 45 minutes with community resident elderly. Information has also been obtained successfully by mail (Slavonic, 1983) and by telephone.

Part A. Functional Assessment

Part A is divided into seven major sections. These sections, in order, with a listing of the number of primary questions in each section (some questions include several parts), a brief description of the conceptualization underlying each of the five dimensions, the manner of operationalization, and question sources, are given below:

Part B. Services Assessment

Section	Question Number
Services 1 question (24 parts)	71	For each of the 24 nonoverlapping services named below, enquiry is made into (a) utilization in the past six months, (b) intensity of present utilization (e.g., frequency), (c) service provider (e.g., self, family and friends, agency), and (d) perceived current need for service. Transportation Social/Recreational Employment Sheltered Employment Educational Services, employment related Remedial training Mental Health Psychotropic Drugs Personal Care Nursing Care Medical Services Supportive Services and Prostheses Physical Therapy Continuous Supervision Checking Relocation and Placement Homemaker-Household Meal Preparation Administrative, Legal, and Protective Systematic Multidimensional Evaluation Financial Assistance Food, Groceries Living Quarters (Housing) Coordination, Information, and Referral

1 NCGCCoA North Carolina Governor’s Coordinating Council on Aging
2	PQ	Preliminary Questionnaire. Although the Short Portable Mental Status Questionnaire (SPMSQ) is part of the Mental Health section it is also used as a screen to determine whether the respondent is capable of answering the OMFAQ reliably. Scores of 4 or higher are an indication to the interviewer that information may also have to be obtained from a knowledgeable informant.

	2
The Validity and Reliability of the OARS Multidimensional Functional Assessment Questionnaire

Chapter Overview

If attention is to be paid to findings, those findings must be valid and reliable. Although validity and reliability do not ensure that findings will be attended to, their presence is essential if findings are not to be dismissed cavalierly. In this chapter detailed information is given on the validity and reliability of the functional assessment section of the OMFAQ. Starting with careful testing to make sure that each item was readily understood, the content, consensual and criterion validity were examined. In particular, because the instrument was also intended to be clinically relevant, we wished questionnaire-based assessments to match professional assessments of the same persons. Of the four areas examined (i.e., economic, mental and physical health, ADL or self-care capacity), significant agreement was found for each. Discriminant validity is not dealt with in this chapter, but the detailed responses from three random sample surveys of community residents, adult day care participants and the institutionalized, presented in chapter 9 attest to the ability of the OMFAQ to discriminate appropriately among diverse groups. In examining reliability we focused on the consistency of subject response over time, and on inter-rater and intrarater agreement. On all these reliability was satisfactory.

The OMFAQ is the result of an iterative procedure, which started by selecting standardized items, pretesting them for comprehension with elderly community and institutional residents, rephrasing them to improve clarity, and rearranging them to facilitate flow. The items of Part A, Functional Assessment, are those which, having survived this process, best discriminated between excellent and totally impaired functioning and were clinically important The items of Part B, Services Assessment, the 24 generically defined services, represent final agreement on a set of non-overlapping, mutually exclusive services which, as a group, were broadly encompassing, omitting no important services available at the time. These procedures were bas...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• Foreword
• Acknowledgments
• Overview
• 1. The Oars Multidimensional Functional Assessment Questionnaire
• 2. The Validity and Reliability of the OARS Multidimensional Functional Assessment Questionnaire
• 3. Psychometric Structure and Computer-Based Rating of Part A. Functional Assessment
• 4. Services
• 5. Aggregating Functional Status and Services Information
• 6. The Oars Model: Use and Uses
• 7. Administration of the OARS Multidimensional Functional Assessment Questionnaire
• 8. Differences between the 1975 and 1988 Editions of the OARS Multidimensional Functional Assessment Questionnaire
• 9. Comparison Norms: Elderly Living in the Community, Institutions, and Attending Daycare
• Appendix A. Variable List and Input Format for the 1988 Version of the OARS Multidimensional Functional Assessment Questionnaire
• Appendix B. Coding AIDS
• Appendix C. OARS Multidimensional Functional Assessment Questionnaire and Services Supplement
• References
• Author Index
• Subject Index