Comparative study of dependency assessment scales, KATZ and SMAF, on the care of elderly people in care institutions

Background and aims: According to KCE (Federal Centre of Expertise for Healthcare) report 73B, SMAF (Functional Autonomy Measurement System of the Elderly), a tool for functional dependence of the elderly, little known in Belgium, offers better support from supervisory staff in care institutions. The study aims to assess the dependency of the elderly by the workload of the supervisory staff using the SMAF scale; and to demonstrate the impact of the use of the SMAF scale in Belgium for better financing of residential establishments for the elderly by supervisory staff. 

Methods: We experimentally verified this statement in a nursing home and nursing home (n=50) by making comparative evaluations between the Katz and SMAF tools; the first being the normative reference for financing in management personnel in Belgium. 

Results: At the end of our experiments, we arrived at a first result according to which SMAF, with more items, makes a better assessment of the dependency of the elderly compared to Katz. In addition to assessing activities of daily living (ADL), SMAF also assesses activities of domestic tasks (ADT). The items assessing cognitive abilities are more extensive than the Katz scale. In view of the results obtained, we reached a second result according to which the use of the SMAF scale in Belgium could be a good calculation basis for financing of paraprofessional care staff. On the other hand, with regard to other care professionals (Nurses and Kiné-Ergo-Logo), no clear trend was observed. 

Conclusions: we can say that SMAF is a good tool for assessing the dependency of the elderly. It can also be used as a basis for funding orderlies. As for other paramedical staff, we recommend working on a large sample.