“I think that Mom has all of the support that she needs, even though she seems to be getting more and more frail. But what if I’m wrong?”
For years, human service nonprofits have applied for grants to support great programs that improve people’s lives. As dollars have become tighter, though, funders increasingly require that nonprofits have a way to measure the impact of their grant-funded services.
But how do we know that a program actually works? Measuring outcomes is especially difficult for prevention services – programs designed to reduce challenges faced by older adults or other at-risk populations.
So JFCS staff members put their heads together to create an evaluation system for seniors that would measure service impact while also providing useful information to help seniors be served more effectively.
And so PFMI – Protective Factors for Maintaining Independence – was born. PFMI, now known as PFMIpro, is an assessment tool that measures senior well-being. The system is at once user-friendly and comprehensive. It not only measures service outcomes, but it also quickly creates a holistic picture of each individual that can be used to direct treatment.
The 20 “protective factors” have been shown by research to directly affect a senior’s ability to live independently. As you might surmise, health, mobility, age and circumstances are important factors. But specific scoring criteria were developed for each factor; this was the key to showing progress (or decline) over time, and directing next steps.
Once the system was developed, it was given to social work researchers at the University of Pittsburgh School of Public Health for rigorous testing and evaluation. The system was validated with data in 2008, and then again last year.
Paul and Margie, an older couple, were living in their home while Margie was under hospice care. After Margie died, a social worker was called to help Paul find alternative living options. A PFMIpro assessment was done for Paul, and this showed that Paul’s increasing social isolation and lack of community interaction was a critical issue. But Paul didn’t want to move to an assisted living facility where he could interact with more people, and his daughter supported his decision.
After a few months, another PFMIpro assessment was done, which showed that Paul’s situation was deteriorating. Lack of contact with other people was affecting the PFMI scores of other health factors, and he was at increased risk of losing his independence.
When Paul’s daughter was able to see the charted decline in scores, she agreed that Paul needed to transition to another living situation. The good news was that PFMIpro pointed to a positive solution that still kept Paul out of a nursing home. An assisted living facility allowed him to maintain most of his independence.
PFMIpro has gone from a paper form with checkboxes to a sophisticated computer program that is now available to other organizations. JFCS has developed a complete package which includes set-up, customization, and continued support for the PFMIpro app. JFCS social workers solved many needs with this one application, and it has potential to become a national model for senior assessment and case management.