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The Determination of Need Protocol

A Method for Establishing Hours of Attendant Care: The Determination of Need Protocol
AANLCP Journal of Nurse Life Care Planning | Winter 2016


Photo credit: Bureau of Labor Statistics
Photo credit: BLS.gov

Designed and adopted by the University of Chicago Gerontology Program for the Illinois Department of Rehabilitation Services (DRS), the Determination of Need Protocol (DON) is a user-friendly form that provides a quick and efficient method for Life Care Planners to estimate attendant care hours for a person with disabilities.

The DON tool provides an uncomplicated method to determine the assistance required to overcome each barrier to function in 11 task areas, assesses the level of support needed, and presents a process to calculate the total of hours of attendant care needed by the individual daily, weekly, monthly, and annually. It is a means to evaluate the full range of activities of daily living (ADL) or independent activities of daily living (IADL), linking the needed hours to tasks that required performance. Severity of disability and impairment specificity are identified and measured for unmet need for support across the full range of task and life areas. The total number of attendant care hours required per week, month, or year can then be quantified and fairly established. Additional benefits of the DON tool include the minimal training required by users to complete and the availability of automated assessment, which minimize errors in calculations carried out by Life Care Planning experts. According the the AANLCP Journal of Nurse Life Care Planning (Winter 2016), “it is the [DON] authors’ hope that other LCP may choose to add this precise, valid, reliable, and easy-to-use protocol to their armamentarium of evidence-based assessment tools.”