Debbie Hommel's A.D. Tips
Dedicated to helping Activity Professionals with the daily operation of their department.
by Debbie Hommel, BA, CRA, ACC, CRTS, Executive Director of DH Special Services
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DEBBIE HOMMEL
Executive Director
DH Special Services
About Debbie

Debbie Hommel, BA, CRA,
ACC, CRTS, is the Executive
Director of DH Special
Services. She is a Certified
Activity Consultant on State
and National level, with over
twenty-seven years of
experience in providing direct
care and consultation to long
term care, medical day care,
assisted living, and ICF/MR
facilities throughout New
Jersey, New York, Maryland,
and Pennsylvania. She is an
experienced trainer and
workshop presenter,
conducting a variety of
seminars throughout the
Tri-State area for the Activity
Professional, Administrator,
and allied healthcare
professional. Debbie Hommel
is an active member of Activity
Professional Associations on
State and National levels. She
is ACC certified through the
NCCAP. She is a founding
member of the New Jersey
Activity Professionals'
Association, serving terms as
Vice President and President.
She received the Weidner
Lifetime Achievement Award
in 1994 and the Monmouth &
Ocean County Activity
Professionals Life
Achievement Award in 1999.
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Understanding the Older Adult
By Debbie Hommel, ACC, CTRS

In order to appropriately program for the older adult, the activity professional needs a
comprehensive understanding of the resident or client – socially, physically and
cognitively.  The activity professional utilizes various methods to get to know the
resident/client.  Observation, 1-1 interaction, a review of accompanying records and
discussion with the care team will provide much information which will help the activity
professional develop an appropriate program for the resident/client.    Initial training for
every activity professional emphasizes the importance of an individualized and thorough
assessment.  This assessment is department specific and the form may vary from
setting to setting.  Overall, the activity professional uses this individualized assessment
process to gather information, as deemed pertinent by the agency or organization.   

Another type of assessment the activity professional should be familiar with is the
standardized assessment.  Standardized assessments are prevalent in health care
settings as a way to gather specific information and assess specific aspects about the
resident/client needs.  Standardized assessments are assessments with clearly
defined procedures for administration.  Many standardized assessments are based on
norms which highlight any abnormalities or exceptions to the norm which are then
identified and treated.    Such assessments are often limited to assessing the specific
characteristic or need it is designed to assess and cannot provide a complete
assessment of the entire person.  Standardized assessments do serve a purpose in
that they provide a consistent framework or standard for all caregivers to utilize.  They
strive to minimize the subjective nature of assessment and allow the assessor to more
accurately address areas of concern.   However, they cannot replace the complete
assessment.

There are a number of common standardized assessment tools used in long term care
facilities today.  Here is a discussion of only a few of the ones most used.  One of the
more popular assessment questionnaires is the mini-mental state examination which
was developed by Folstein in 1975.  The goal of the questionnaire is to assess various
cognitive functions such as memory, arithmetic and orientation.    Once the
questionnaire is administered, the final score will give the assessor some
understanding of the level of cognitive loss.  There are many more standardized
assessment tools and scales, including the FAST (Functional Assessment
Standardized Test).  This assessment tool was created by Barry Reisberg, MD, and
colleagues at the New York University Medical Center’s Aging and Dementia Research
Center.   The scale places the resident/client within one of seven stages of functional
decline. The Clinical Dementia Rating Scale was developed by John C Morris and his
colleagues at Washington University School of Medicine.  This scale is used to quantify
the severity of the symptoms of dementia.  It tests six categories of cognitive functioning
including: memory, orientation, judgment, community affairs, home and hobbies, and
personal care. The final score ranges over five points from normal to severe
impairment.   The Geriatric Depression Rating Scale (GDS) is a popular standardized
assessment which was first developed in 1982 by J.A. Yesavage and others.  This is a
simple questionnaire designed to screen for depression in the elderly.  There is a short
and long version of this questionnaire which has proven effective through the years in
screening residents and clients for signs and symptoms of depression.  

An often misunderstood component of such standardized assessment tools is that they
need to be completed by an individual who has been oriented to the proper method of
administration.  How the questions are asked, the setting in which the assessment is
conducted, and how the answers are scored or coded all can impact on the accuracy of
the assessment scale.  Most standardized assessment scales have clear and specific
guidelines as to the implementation of the assessment and should be followed
clearly.  

Although it is important and helpful to be aware of the various rating scales,
standardized assessment tools and questionnaires, the activity professional should
never overlook the significance of the personal interview and 1-1 time with each
resident/client served.  These standardized rating scales are effective for screening and
identifying areas of risk or need but should never replace the individualized
assessment, both formal and informal, conducted by the activity professional.  

  • Geriatric Depression Scale
  • FAST Scale
  • Clinical Dementia Rating Scale
  • Mini Mental State Exam