A New Phenomenon: MDS Interview Fatigue

VP, Curriculum Development, American Association of Nurse Assessment Coordination

Good Afternoon, ProviderNation.

Our guest blog today comes from Judi Kulus, vice pesident, curriculum development, American Association of Nurse Assessment Coordination.

“Resident interview fatigue” is not found in a formal lexicon, at least not as far as I know.  However, I hear facility staff using it frequently to describe some of the feelings their residents have about the frequency of, and process for, the minimum data set (MDS) 3.0-related interviews for cognition, mood, pain, and preferences.

Please don’t take me wrong, I’m a big advocate of the MDS interviews and for the benefits they have in soliciting resident voice and resident choice. But I often hear staff discuss how they go to interview a resident, knock on the door, and the resident says, “Sock, blue, bed” (which is part of the cognition interview) before things even get started.

Moreover, it’s challenging when a resident who has pain denies it during the interview, while other residents just refuse to participate.

Many of the challenges that facility staff encounter are of our own making. For example, the nurse decides to take a quick moment to interview the resident before she goes on break, so she drops in on the resident to attempt the interview.

The resident is not prepared for a visitor and the interview is rejected or the resident is not invested in open dialogue because they want it to end quickly.

Rather than using the “drop in” approach, I recommend setting up a scheduled appointment whenever possible so the resident can be prepared to receive us into their home.

It’s also helpful to describe the types, purposes, and frequency of the interviews in the admission orientation process so that residents and family are informed ahead of time that the interviews will take place.

If the resident knows that you ask these questions in order to provide the care and services that they desire, cooperation will be enhanced.

I have also found the interview techniques of probing, echoing, unfolding, and disentangling (as described in the Resident Assessment Manual) are invaluable to therapeutic interviewing.

Judi Kulus, NHA, RN, MAT, RAC-MT, C-NE

(jkulus@aanac.org)

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Filed under health care, Long term care, Post-acute care

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