Author: Clarkson P, Venables D, Hughes J, Burns A and Challis D
Journal: Psychological Medicine, 2006
Volume/pages: Vol 36, pp1011-1021

About the study
In this UK based randomized controlled trial, integrated assessment was compared with care management assessment only, for older people at risk of care home admission. Integrated assessment involved care management assessment plus clinical assessment by an old age psychiatrist or geriatrician. The main outcome of interest was admission to a residential home at six or twelve months from baseline.

Findings
129 participants received an integrated assessment, and 127 received a standard assessment. While care managers recommended 100% of participants for care home placement, clinicians made this recommendation for only 15%. In the study setting there were no actual reductions in numbers of placements for the intervention group as the final decision still rested with care managers, but clinician involvement did succeed in delaying admissions.

Key messages

• Multidisciplinary assessment has the potential to delay admission to a care home for individuals, and even reduce rates of admission overall
• Placement in a care home or nursing home may need to be conditional on the result of an integrated assessment if this type of joint working is to have a real impact