Use of RAI assessment in client work – Frequently asked questions

Yes. Social and health care services planned for the client can also be provided as remote visits, which are equivalent to planned in person visits to the client. They are accounted for in the RAI assessment according to the professional title of the person performing the visit.

Responsibility for the RAI assessment always lies with a social and health care professional who has the competence required to use the RAI assessment tool.

Professionals in different roles encounter older persons in different situations and observe based on their professional competence. Conducting a RAI assessment requires multifaceted information about the client’s situation, functional ability, strengths and performance. Therefore, it is important to use the observations and documentation of all professionals involved in providing the client’s services.

A student or care assistant cannot be the responsible assessor unless they hold the required professional qualification in social and health care. They can participate by contributing their observations and information about the client’s everyday life.

Yes, if unit staff have access to information about the therapy plan, implementation and evaluation. The information can be obtained from the client or the client’s close person.

Yes, when it is documented in the same client plan as the client’s other care and services.

Yes. A physiotherapy plan prepared by a physiotherapist can be implemented by social and health care professionals who have training in rehabilitation oriented care work.

In the IADL item Managing medication:

If staff perform more than 50% of medication related tasks (e.g. ordering medicines, renewing prescriptions, dispensing medicines into a dosette or robot), the client needs the maximum level of assistance with medication management. In such a situation there is no difference between performance and ability.

If staff perform less than 50% of the tasks, the client’s need for assistance is defined according to how much help the client needs.

When assessing functional ability, it is important to identify the client’s actual performance during the assessment period and the client’s ability.

Example: telephone use: The client normally uses the phone well, but during the assessment period the client has a cast on the right hand, which prevents phone use. In this case, record under performance that the function was not performed at all, and under ability that the client is independent and does not need help, preparation or guidance.

No. The item assesses only how the client physically manages shopping in a store, selecting items and paying.

For the client’s overall medication, it is important that all prescribed medicines are recorded. If the client has not taken a PRN medicine during the assessment period, mark it as “not taken” under Medicine taken/not.

Participation means going through the purpose of the RAI assessment and its questions together with the client. Participation in the RAI assessment requires interaction with the client when answering the questions.

It is sufficient that the client has expressed an opinion about some of the questions, even if, for example, memory disorder or reduced functional ability prevented participation in other parts of the assessment.

Merely informing about the assessment is not participation.

This means the total time a person is alone during daytime.

Consider the morning and afternoon hours of the day, when there would be opportunities to maintain social relationships that affect psychosocial well being.

Night time spent sleeping is not considered.

The client’s and patient’s right to self determination is provided for in legislation. Self determination is the starting point, and the professional should strive to implement care and services with respect for self determination and in mutual understanding with the client. Exceptions are also provided by law, i.e. acting against the client’s or patient’s will or consent is allowed only on legal grounds.

The client therefore has the right to refuse the RAI assessment. If the client refuses, assess functional ability and service needs, where possible, using other methods in mutual understanding with the client.

When the client refuses, the client must be informed of the significance of the RAI assessment for service and care planning and how refusal affects planning. Necessary care and services cannot be denied on the grounds that the client refuses the assessment. However, insufficient information about the client’s health, functional ability, resources and need for help may affect care and service planning — for example, if the person preparing the client plan cannot understand the client’s needs to the same extent without the completed RAI assessment.

Act on the Status and Rights of Social Welfare Clients (Finlex, in Finnish)
Social Welfare Act (Finlex, in Finnish)

If you cannot answer a question in the RAI assessment, read the question in full and check what the RAI manual instructs for that specific item.

Discuss the issue with your colleagues and review the client records if necessary.

Raise the question with your area’s RAI coordinator or your immediate supervisor.

If needed, you can send the question to rai(at)thl.fi together with the RAI coordinator.

The RAI manual and assessment form are available in THL’s RAI Extranet, where your organisation’s contact persons have login credentials. They can save the material in the organisation’s intranet or share it by email with staff. Ask your immediate supervisor who the contact persons are in your organisation. THL updates the manuals and forms annually, so ensure you are using the latest version.

Note: RAI manuals and forms may be shared only with the organisation’s staff, electronically or in printed form, and only for the agreed use. The interRAI organisation owns the licence rights, and free distribution is not permitted.

Printed materials must be disposed of appropriately when no longer needed.

When you conduct a RAI assessment, you will find the assessment specific manual text next to each assessment question.

An OID code is a unit specific identifier used to identify a unit in Kanta Services.

The codes are defined in THL’s register of social and health care organisations, maintained in the code service.

Instructions for finding and checking OID information are provided under “Checking information in the register of social and health care organisations and the IAH code system” on the page Register of Social and Health Care Organisations.

Register of Social and Health Care Organisations (in Finnish)

A client is defined as bed bound when the client lies, rests or spends time in bed in their own room for 22 hours per day or more, on at least two of the last three days. The client’s ability to walk, to stand, and difficulties related to these appear in other questions in the RAI assessment.

If the client is unable to stand up independently, with or without assistive devices, the answer is: “the problem has occurred every day.”

If the client is unable to stand up independently, the answer is: “the problem has not occurred.”

If the client is unable to walk, answer the item Unsteady gait with: “the problem has not occurred.”