Biopsychosocial Assessment of Older Adults

Biopsychosocial Assessment and Aging

Aging involves a whole person, so a biopsychosocial assessment of our clients is critical to guide effective interventions. Biopsychosocial assessment is essential in guiding effective interventions because it is a model that views health and illness in old age from physical and biological factors. In addition, this model views health and illness in aging from the aggregate effects of a lifetime of social, psychological, and social processes. Therefore, the use of this model provides a framework to examine health and illness from a biological course of decline throughout the lifespan (Rook, Charles & Heckhausen, 2011). This paper examines biopsychosocial assessment tools used to examine health and illness in old age. This evaluation discusses tools used for assessing physical/social health and mental health screening tools.

Mental Health Screening Tools/Assessments

The biopsychosocial model of health and illness incorporates three major components i.e. biological, psychological, and social. These three domains form the basis with which this model is used to examine health and illness at different developmental stages including old age. The biological domain examines the course of decline throughout an adult’s lifespan as well as physical changes. Physical changes and biological decline in old age increase older adults’ vulnerability to acute and chronic conditions. On the other hand, the social domain relates to interpersonal factors like community activities and social interactions with respect to their effect on health and illness. The psychological domain relates to mental and emotional aspects of health and behavior in relation to behavior (Hardie, 2021). This implies that the psychological domain is the premise for mental health screening or assessment in aging.

There is a wide range of mental health screening tools/assessments that can be used in aging. These assessment or screening tools are used depending on the specific mental health condition or aspect of wellness to be assessed. Kendall (2019) notes that the most common health problems affecting older adults in the psychological domain are depression, delirium, and cognitive impairment. The Mini Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS), and the mini-Addenbrooke’s Cognitive Examination (M-ACE) are examples of mental health screening tools used for the assessment of cognitive impairment. They provide information regarding cognitive function including aspects of language, memory, and orientation. Assessment of depression in older adults can be carried out using the Geriatric Depression Scale, Depression Inventory, and the nine-item Patient Health Questionnaire. For delirium, the Delirium Rating Scale, Delirium Index, Short Confusion Assessment Method, and Neelon and Champagne Confusion Scale can be used.

Two Assessment Tools

The application of biopsychosocial assessment in counseling older adults involves using different screening tools for the different domains. One of the screening tools that could be for mental health assessment during counseling is the Clock Drawing Test. This is a short assessment tool used to assess cognition in different ways. Some of the common ways of using this test include asking clients or patients to copy an image of a clock, draw a clock from memory, add hands showing a certain time to a clock’s image, or add numbers to a clock face (Kendall, 2019). Clock Drawing Test uses different scoring systems depending on the specific way it is employed when working with a client. Despite using different scoring systems, the sub-scores of the various aspects of the drawing are used to indicate the level of an individual’s cognitive impairment. Clock Drawing Test would be a suitable way for mental health assessment in aging as it has proven useful and effective in diagnosing cognitive impairment in evidence-based clinical practice.

On the other hand, the assessment of physical or social health could involve the use of the Global Assessment of Functioning (GAF). This is an assessment instrument used to rate the social, psychological, and occupational functioning of a person. GAF is renowned for its simplicity and provision of insights into how patients or clients are doing (Aas, 2014). The use of this tool for the assessment of physical or social health is influenced by the fact that it covers a wide range of issues relating to social, psychological, and occupational functioning. As a result, this screening tool provides results of one’s functioning in more detailed clinical descriptions.

Clock Drawing Test and GAF would form the basis of counseling approaches as they are simple yet comprehensive assessment tools for mental health and physical/social health respectively. In counseling, these screening tools would be integrated as part of the first-line screening instruments for clients with mental, physical, and/or social health issues. They will provide information regarding the functioning ability and cognitive wellbeing of individual clients. Insights obtained from these assessment tools can then be used to guide the next steps in the counseling process.