Domain 8 - Engagement and motivation (Contextual Domain)

Overview

This domain considers the older adult’s awareness of the mental health issue and their capacity and willingness to engage in or accept assistance. Assessment of an individual on this domain should include the persons:

  • Ability and capacity to manage the condition.

  • Motivation to access necessary supports (critical if considering self-management options).

Some older adults may not have the agency or resources required to seek and access services and support independently of a support person, caregiver, or family member. Subsequently, the initial assessment and referral process needs to include support people, caregivers, and family members in discussions and decision-making where appropriate.

PRACTICE POINT - checking in when engagement or motivation is low

A follow-up check-in helps determine if the recommended information, resources, and services are being utilised and perceived as helpful. Proactively “checking in” or encouraging the person to “check back” is essential when engagement or motivation is low. A plan for check-in should be made at the point of referral and documented.

The check-in should explore the following questions:

  1. Is the person engaging with the recommended information, resources, and services? If the person is not engaging, it is essential to re-examine motivation and explore reasons for the lack of engagement (domain 8).

  2. Does the person think that the recommended information, resources, and services are/were helpful?

  3. Is there evidence of deterioration or emerging/changing factors relating to suicide or harm to self or others?

  4. Is the person experiencing new or worsening social and environmental stressors?

  5. Discuss and document the next steps determined in collaboration with the person. The next steps might include:

  • Continue existing service arrangements

  • Build-in additional supports

  • Initiate a referral to a different level of care

Scoring

0 = Optimal

  1. The person is motivated to participate in the recommended services and support.

  2. The person is capable of taking an active role in managing the condition.

1 = Positive

  1. The person is mostly willing to accept and participate in the recommended services and support.

  2. The person can mostly take an active role in managing the condition.

2 = Limited

  1. The person is hesitant to accept and participate in the recommended services and support.

  2. The person has limited ability to take an active role in managing the condition.

3 = Minimal

  1. The person is very reluctant to accept or participate in services and support.

  2. The person has not participated in services and support in the past, despite requiring them, due to low levels of engagement or motivation.

4 = Disengaged

  1. The person refuses to accept or participate in the recommended services and support.

  2. The person has minimal ability to take an active role in managing the condition.