Functioning and service needs of older people – RAI benchmarking data 2022

Cognitive impairment is common, and rehabilitative activities are limited among clients of home care and long-term care facilities.

In Finland, assessing the functioning of older clients using the RAI (Resident Assessment Instrument) is statutory (STM 980/2012) in regular services and client guidance for older people. Uniform assessment creates a basis for client-oriented and systematic services as well as monitoring and developing services.

According to RAI benchmarking data, more than half of home care clients (54 %) and almost all clients in long-term care facilities (88 %) had impaired cognition in 2022. In about half of the cases, the clients or their caregivers believed in the possibilities of rehabilitation, in home care (54 %) slightly more often than among clients in long-term care facilities(45 %). However, only a few received rehabilitation or other therapy from specialized workers. About two-thirds (72 %) of home care clients participated in their functioning and service needs assessment. About half (51 %) of the clients in the long-term care facilities participated in their assessment.

In 2022, there were apparent differences between the current wellbeing service counties in the functioning and service needs of RAI-assessed clients and in the coverage of RAI assessment data. For example, regional variation was extensive in the frequency of falls and the use of acute hospital care. The participation of relatives and/or other informal helpers, and the expression of the client's care goals also varied greatly by wellbeing service county. The differences may be due to different practices but also to differences in the client structure and RAI assessment competence of the care workers, which must be considered when interpreting the results.

In this report, we examine the situation in 2022, when there were 48,815 RAI-assessed clients in home care (43 % of the service recipients) and 47,629 (64 % of the service recipients) in long-term care facilities.

Download the statistical report in Finnish

Information on cognition, everyday performance, belief in rehabilitation, and participation of clients of home care and long-term care facilities. Detailed information is available in the statistical report. — Functioning and participation of home care and long-term care facility clients in 2022.

Background information

Quality description

Description of statistics

RAI, or Resident Assessment Instrument, is a standardized instrument for assessing functioning and service needs. RAI assessments are carried out in regular services for older people at least every six months.

The follow-up data collected from the client helps to plan care, rehabilitation, and services, and provides information for assessing the effectiveness of the services. The RAI indicators formed in the RAI assessment describe, for example, the client's state of health, functioning and individual resources, as well as the need for care, services, and rehabilitation. The indicators and variables included in the statistical report have been selected based on the data's relevance from the knowledge management perspective.

The data include the RAI assessments of clients aged 65 or over in home care and long-term care facilities, which were extracted from THL's RAI data pool in November 2023. Only comprehensive assessments from 2022 were included – not partial assessments. The data are reported by wellbeing service county, including Helsinki and, in the case of long-term care facilities, also Åland.

The use of RAI tools has been mandatory in Finland since April 2023 when assessing the service needs of older people in regular services and client guidance (Act on Supporting the Functional Capacity of the Older Population and on Social and Health Services for Older Person). However, the RAI was introduced in Finland already in 2000, so some regions and organisations already have more than two decades of experience in its use. The collection of assessment data for THL is based on the Act on the National Institute for Health and Welfare. The content of the RAI is maintained and developed, and its rights are owned by interRAI, an international network of researchers and experts.

Source

Iäkkäiden toimintakyky ja palvelutarpeet – RAI-vertailutiedot 2022
Funktion och servicebehov hos äldre – RAI-jämförelsedata 2022
Functioning and service needs of older people – RAI benchmarking data 2022

Statistical Report 3/2024, 31.1.2024. THL