Family help available

This article considers the neglected problem of assessment of family function relevant to the placement and level of care for persons with long-term disabilities. An examination of both practical clinical issues and policy shows the need for improved means of assessing families. A review of the literature on family assessment shows the mixed success of past attempts to quantify family structure, dynamics, and support. Data from a prospective study involving an experimental measure of Family Help Available (FHA) are then presented. FHA was found to be a strong predictor of nursing home placement and disability support costs. Nursing home versus home residence could be predicted with 94% accuracy, but only by using both FHA and disability. Greater FHA was essential to compensate for greater patient disability. One can neither place a disabled patient nor understand disability-related costs without assessment of family support.