Use of the Care Dependency Scale
Use in clinical practice

Populations
The CDS can be used in different health care settings (community care, home care and institutional care), populations (e.g. patients admitted on different wards in a hospital, nursing homes, residences for the learning disabled), and age groups.

Use in the caring process
The CDS is intended to be used in the first stage of the caring or nursing process as a need and/or risk assessment tool. The scale gives no direct answers, but indicates directions so that nurses and other health carers can focus on care needs amenable to nursing or caring diagnoses. The CDS is a scale derived from observed behaviour, so the accuracy of the assessment depends on the degree to which the health carer is familiar with the daily functioning, care demands and needs of the patient. Therefore, practising nurses or health carers are in the best position to assess patients, especially in situations where the latter are unable to communicate or have limited communication capabilities.

The CDS is an aid to assessing patient’s needs and the degree of help from another person required to meet these needs. This knowledge may enable health carers to develop a draft care plan, which they may discuss in a multidisciplinary consultation. The aim of this consultation would be to determine joint diagnoses, objectives and interventions that specify the input of different professionals to patient care. Repeated assessments with the CDS provide data for monitoring change in patient status and, potentially, assessing the success of interventions in decreasing patient’s dependency.

In practice, the CDS is intended to be used in the first stage of the caring process as a need and/or risk assessment tool. The CDS is an aid to assessing patients’ need and the degree of professional assistance required meeting these needs. This knowledge may enable carers to develop a draft care plan, which they may discuss in a multidisciplinary consultation. The aim of this consultation would be to determine joint diagnoses, objectives and interventions that specify the input of different professionals to patient care. Repeated assessments with the CDS provide data for monitoring change in patient status and, potentially, assessing the success of interventions in decreasing patient dependency. In addition, the CDS sum score is useful to generate management information on a population level.

Example of a CDS item, used for goal planning:

Eating and Drinking
The extent to which the patient is able to satisfy his/her need for food and drink

1. Person is unable to take food and drink
2. Person is unable to prepare food and drink unaided; is able to put food and drink into his/her mouth
3. Person is able to prepare and put food and drink into his/her mouth unaided with supervision; has difficulty determining quantity
4. Person is able to eat and drink unaided with some supervision
5. Person is able to prepare meals and to satisfy his/her need for food and drink unaided

Example of a CDS item, used for research purposes:

Eating and Drinking
The extent to which the patient is able to satisfy his/her need for food and drink

1. Person is completely dependent on nursing care
2. Person is to a great extent dependent on nursing care
3. Person is partially dependent on nursing care
4. Person is only to a limited extent dependent on nursing care
5. Person is almost independent on nursing care

Example of a CDS item, used for self-assessment

Eating and Drinking
Are you able to ensure that you eat and drink enough each day?

1. Someone has to help me with eating and drinking; without their help I get nothing
2. If someone prepares food and drink and gives it to me, I can manage the rest
3. I can make a sandwich and a drink for myself; a hot meal has to be prepared by others and given to me
4. I can make sure that I get enough to eat and drink; however, it costs me a lot of trouble and the provision of ‘meals-on-wheels’ is a godsend for me
5. I prepare my own food and make sure that I drink enough
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