The starting point is always the client and identifying the client's changing needs. Therefore, RAI assessments are carried out regularly. Up to date assessment data allows you to track changes in the client's situation and functional ability and to respond quickly and preventively to issues you observe.
Ensure comprehensive assessments
Comprehensive assessments include the client's first RAI assessment, regular follow up assessments, and assessments conducted when the client's situation has changed significantly. In a comprehensive assessment, you answer all questions in the RAI instrument and assess the client's functional ability and needs holistically. Comprehensive assessments support the aims of the Act on Services for Older Persons and produce national benchmark data for service management and research.
A partial assessment allows you to monitor a specific area, such as rehabilitation progress. It is narrower in scope than a comprehensive assessment and cannot replace one. Partial assessments do not produce national, comprehensive benchmark data.
Learn more about the types of RAI assessments in THL’s RAI online training (Moodle, in Finnish)
RAI assessment in client guidance for older people
Carry out a comprehensive assessment using the RAI instrument in client guidance for older people, when the initial evaluation indicates that they will likely need support in regular home care, informal care, family care, communal living, or long-term care facilities. The initial assessment is conducted by a social or healthcare professional responsible for determining service needs and who has the broad expertise required for this task.
The process for assessing service needs may vary between service providers. Ensure that the client's functional ability and service needs have been evaluated using the RAI instrument as a comprehensive assessment during the service needs determination, before any decision is made about granting regular social services.
RAI assessment in regular home care for older people
Carry out a comprehensive assessment at the start of regular home care, every six months, and whenever the client's situation or service provision changes significantly.
RAI assessment in long term care facilities for older people
Carry out a RAI assessment when the client enters long term 24 hour care. After that, conduct a follow up assessment whenever the client's situation changes significantly and, based on professional judgement, regularly every six months.
If follow up assessments are conducted only when the client's situation changes, it is essential that your unit has effective practices for monitoring the client's condition, identifying significant changes, and completing the assessment promptly once a change is detected. Check your unit's practices with your supervisor, RAI contact person or RAI coordinator.
Identify significant change in the client's situation
A significant change means the client's condition or need for support has changed in one or more of the following areas:
- Activities of Daily Living (ADL) or decision making ability (cognition)
- Continence
- Unplanned weight loss
- Development of at least a stage II pressure ulcer when no other pressure ulcers have been present
- Disease or condition affecting the stability of health status
- Deterioration or improvement of general condition
- Increased or decreased need for and access to support
- Significant changes in service provision, e.g. situations where the client's health or circumstances change so that the client plan or implementation plan needs to be updated
- An sudden change that is not expected to return to baseline within a few days. Such changes may result from illness, deterioration of a chronic condition, or an accident
- The client returns to the service after hospital care or a rehabilitation period.
Regular RAI assessments generate comprehensive benchmarking data
THL’s RAI benchmarking reports and other RAI benchmarking databases are based on RAI assessment data for clients assessed during each six month period.
If no RAI assessment is completed for the client within a six month period, the client’s data are not included in the RAI dataset on which benchmarking data is based.
Semiannual RAI assessments ensure that RAI benchmarking data reliably reflect the client base’s service needs or the quality of services across the entire unit.