Standardised functional assessment in long-term care for older people : perspective of Finnish care workers

Abstract

Objective measures and documentation are increasingly used in the care for older people to promote efficiency and productivity. A standardised assessment of functional capacity is one such measure. In this study, we examined the meanings given to standardised functional assessment by care workers who provide long-term care for older people. Gathered from eight Finnish long-term care facilities, the data consisted of one-on-one interviews with practical and registered nurses (n = 24). In the data analysis, we employed the discursive approach. We identified three discourses in the care workers’ talks that differed in the meaning given to standardised functional assessment in the process of care: part of the bureaucracy, a missed opportunity and a threat to person-centred care. Care workers described these assessments as constituting a routine part of their job but expressed uncertainty about their role and the practical benefits in actual care work. They even called into question these assessments’ relevance to quality care delivery. To be a meaningful part of care practice, it is essential that there be a shared understanding of the rationale behind functional assessments in the care organisation and that care workers themselves can see the outcomes of these assessments in their daily work.