B0800: Ability to Understand Others

B0800: Ability to Understand Others

Item Rationale

Health-related Quality of Life

• Inability to understand direct person-to-person communication

— Can severely limit association with others.

— Can inhibit the individual’s ability to follow instructions that can affect health and safety.

Planning for Care

• Thorough assessment to determine underlying cause or causes is critical in order to develop a care plan to address the individual’s specific deficits and needs.

• Every effort should be made by the facility to provide information to the resident in a consistent manner that they understand based on an individualized assessment.

Steps for Assessment

1. Assess in the resident’s preferred language or preferred method of communication.

2. If the resident uses a hearing aid, hearing device or other communications enhancement device, the resident should use that device during the evaluation of the resident’s understanding of person-to-person communication.

3. Interact with the resident and observe their understanding of other’s communication.

4. Consult with direct care staff over all shifts, if possible, the resident’s family, and speechlanguage pathologist (if involved in care).

5. Review the medical record for indications of how well the resident understands others.

Coding Instructions

• Code 0, understands: if the resident clearly comprehends the message(s) and demonstrates comprehension by words or actions/behaviors.

• Code 1, usually understands: if the resident misses some part or intent of the message but comprehends most of it. The resident may have periodic difficulties integrating information but generally demonstrates comprehension by responding in words or actions.

• Code 2, sometimes understands: if the resident demonstrates frequent difficulties integrating information, and responds adequately only to simple and direct questions or instructions. When staff rephrase or simplify the message(s) and/or use gestures, the resident’s comprehension is enhanced.

• Code 3, rarely/never understands: if the resident demonstrates very limited ability to understand communication. Or, if staff have difficulty determining whether or not the resident comprehends messages, based on verbal and nonverbal responses. Or, the resident can hear sounds but does not understand messages.

DEFINITION

ABILITY TO UNDERSTAND OTHERS

Comprehension of direct person-to-person communication whether spoken, written, or in sign language or Braille. Includes the resident’s ability to process and understand language. Deficits in one’s ability to understand (receptive communication deficits) can involve declines in hearing, comprehension (spoken or written) or recognition of facial expressions.