A guide for considering performance-based assessments when determining a patient's capacity for safe, independent living

Clinicians treating older adults are often asked to evaluate the everyday functioning capabilities of their patients. Difficulties with daily functioning are part of the diagnostic criteria for most neuropsychiatric disorders, including dementia. Many methods of assessing daily functioning exist, including self- or collateral reports (through clinical interview or structured rating scales), direct home- or community-based observations, and performance-based measures conducted within the clinic or laboratory. Performance-based measures use simulated or role-play functioning scenarios and have the key advantage of decreasing reporter bias; these instruments may provide complementary information to subjective reports and/or field observations. Thus, treating clinicians should consider incorporating performance-based assessments as part of the diagnostic process to establish (or rule out) presence of functioning impairments and when developing recommendations about a patient's capacity for safe independent living.