Assessment of the needs of older people by district nurses and social workers: a changing culture?

This paper reports on a qualitative study which explored the process of assessment of the needs of older people by district nurses and social workers. In the UK, district nurses and social workers are two of the key practitioner groups responsible for assessing the health and social needs of older people in the community. Assessment of need is one of the core skills of community practitioners, with the potential to substantially affect a person's quality of life. An ethnographic approach was taken to analysing the assessment process in district nursing and social work, encompassing interviews with practitioners and observation of assessment practice. The similarities and differences between assessment of the needs of older people as conducted by district nurses and social workers are explored, with a view to identifying particular areas of expertise in this crucial area of practice. The study findings suggest that there are a number of similarities in the assessment practice of district nurses and social workers, but that the focus of their assessments differs in important respects. Organisational and educational differences and resource constraints were found to have a marked effect on producing differences in the process of assessment between the two groups.