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  1. Maximus
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  3. The value of a person-centered approach when assessing people with complex needs

The value of a person-centered approach when assessing people with complex needs

Nancy Shanley

Nancy Shanley

August 8, 2024

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Most people feel apprehensive when encountering a new situation. Knowing what to expect can help.

Older man points to sheets of paper held by an older woman. They are seated at a table.

When older adults and individuals with disabilities seek long-term services and supports (LTSS) or home and community-based services (HCBS), they must first go through an eligibility assessment to confirm they have a need for these services and supports. Many experience some uncertainty about the eligibility process. And most hope that the professional talking with them understands why they need support, what their experience without support is like, and which type of help they want to receive.

For LTSS and HCBS assessment professionals, this means gathering correct, relevant, and meaningful information about each person’s support needs and goals. For the best outcomes, our assessments must deliver both accurate information and a positive experience for the individual. Accuracy is key to help ensure individuals receive the right type and intensity of services in the right settings to align with their unique constellation of needs, goals, and preferences. Positive experiences during this entryway to services reinforce the person’s engagement, self-advocacy, sense of autonomy, and self-determination.   

As highly trained assessment professionals, what can we do to make someone feel comfortable and respected throughout the assessment experience?

The Person-Centered Approach

A person-centered assessor takes the time to let each person know what they’ll experience during the assessment process, how the information gathered may inform their services and settings options, and the choices they (and their caregivers) may need to make. This approach provides reassurance that we’ve thoroughly and accurately accounted for a person’s unique needs. It also aligns with the LTSS/HCBS values of informed choice, individual empowerment, and self-determination while driving outcomes that more thoroughly reflect individual needs and priorities.

After supporting LTSS and HCBS programs as an assessment professional for more than three decades, it’s clear to me that many benefits, both to the individuals we assess and our state clients, spring from an intentional, rigorous, consistent application of a person-centered approach to assessment encounters.

By applying a person-centered approach, we can achieve three key goals:

  • Improve assessment accuracy by eliciting more precise and thorough information from assessed individuals.
  • Increase the individual’s engagement and confidence in assessment outcomes and in the decisions those outcomes impact.
  • Reinforce a sense of agency, choice, and internal locus of control as individuals navigate often complex pathways to services and supports.

A person-centered assessment approach fosters a comfortable environment where individuals are heard and respected. It allows for the exchange of valuable information tailored to each person's unique needs and reinforces someone’s sense of agency regarding the assessment experience itself, thereby increasing their confidence in advocating for their goals and preferences during post-assessment service planning.

Four Guiding Principles

When interacting with assessment participants, there are four guiding principles for person-centered assessors that lead to success:

  1. Explore each individual’s communication and interaction preferences and adjust to their style accordingly. Instead of assuming that a one-size-fits-all approach is effective, person-centered assessors adapt their style to suit the individual's needs.
  2. Use active listening skills. Assessors frequently stop to verbally reflect back what they understood the person to have said. When the person confirms or corrects this reflection, they gain better control over their own message, and the assessor obtains a more accurate view of the person’s experience.
  3. Empower individuals with information and choices. To feel more in control, people need to know what to expect before, during, and after an assessment. They need affirmation that the assessment may yield options from which they can choose.
  4. Remain acutely aware of cultural influences and trauma-related sensitivities. Person-centered assessors prioritize understanding and addressing the cultural preferences that are important to the person they’re assessing.

The Path Forward for Assessments

Mastering a person-centered approach to assessment takes time to learn and be attuned to individual communication preferences. The rewards of someone feeling comfortable and engaged throughout their assessment and empowered with information and choices justify the effort and time invested by assessors.

When assessments help determine service delivery or care plan decisions, the way individuals experience the process matters. By applying a person-centered approach when conducting eligibility assessments, we help make an interaction that could be filled with uncertainty into an affirming experience where someone feels they were able to accurately communicate both their needs and their hope for support.

This insight also appeared in McKnight's Home Care.

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About the author

Nancy Shanley

Nancy Shanley, Managing Director, Clinical Services, U.S. Services

Nancy Shanley is a leader within our clinical services team and has consulted with CMS and states about operational, policy, and infrastructure issues underpinning successful LTSS assessments, service rates, and rebalanced LTSS programs.

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