How to Prepare for an interRAI Assessment NZ

The interRAI assessment is a single clinical conversation that determines how many funded home support hours your parent receives. Get it right and your parent gets the help they need. Understate the difficulties — out of politeness, pride, or a good day — and the algorithm outputs a low-acuity score that leaves your family covering the gap privately.

Here's what actually happens during the assessment and how to prepare.

What the interRAI Tool Measures

The interRAI Home Care (interRAI-HC) is a standardised clinical instrument used across New Zealand by all NASC assessors. It evaluates 236 items across multiple domains:

• Physical mobility: walking, transfers, stair climbing, balance, fall history
• Cognitive performance: short-term memory, decision-making, comprehension
• Activities of daily living (ADLs): bathing, dressing, toileting, eating
• Instrumental activities of daily living (IADLs): cooking, cleaning, laundry, managing finances, using transport
• Clinical stability: medication management, wound care, chronic pain, continence
• Psychosocial health: depression indicators, social isolation, behavioural changes
• Informal caregiver status: hours of care provided, carer distress level, sustainability of the caregiving arrangement

The assessment takes one to three hours and is conducted by a registered nurse, occupational therapist, or social worker in your parent's home.

The Worst-Day Principle

This is the single most important concept to understand before the assessment. The interRAI scoring algorithm is designed to capture your parent's worst-day performance, not their best-day capabilities.

If your parent can shower independently on a good day but needs hands-on help three days a week, the assessor needs to hear about the three bad days — not the good one. If your parent managed to cook dinner yesterday but burns meals twice a week and forgot the stove was on last Tuesday, that's what matters clinically.

The natural human instinct — especially among the generation that grew up not wanting to be a burden — is to present the best version of themselves. Many parents will tell the assessor "I manage fine" while their family knows they haven't showered in a week. This polite minimisation directly reduces the funded hours they receive.

How to Prepare

Keep a five-day diary before the assessment. Record every incident: falls, near-misses, confusion episodes, missed medications, inability to complete tasks, sleep disturbances, and moments where you had to intervene. Hand this diary to the assessor — it provides objective, time-stamped evidence that overrides any in-the-moment minimisation.

Be present during the assessment. A family member or someone holding an Enduring Power of Attorney should attend. You can provide additional context when your parent understates their difficulties. The assessor expects this — they know that cognitive impairment often includes reduced self-awareness.

Document your own carer burden. The interRAI includes a specific section evaluating informal carer distress. If you're sleeping poorly, missing work, experiencing anxiety, or physically exhausted, say so clearly. Your distress score directly influences the respite and Carer Support allocation.

Gather medical records. Bring a current medication list, recent hospital discharge summaries, GP letters, and any specialist reports. The assessor builds a clinical picture — documentation strengthens the case for higher-level support.

How Scoring Determines Hours

The interRAI algorithm categorises your parent's overall needs as very low, low, medium, high, or very high. This classification maps to a funded hours allocation:

• Very low / low: minimal funded support — perhaps 1.5 hours per week of personal care
• Medium: moderate allocation — several hours per week across personal care and (if CSC-eligible) household management
• High / very high: substantial daily support — potentially multiple visits per day

The exact hours are not published in a fixed table because NASC agencies have regional budgets and prioritisation models. But the interRAI score is the primary input — a higher clinical acuity classification means more funded hours.

If the Score Is Too Low

If the assessment results in an allocation that doesn't match your parent's actual needs, you have three options:

1. Request a reassessment immediately — provide the diary evidence and any new medical documentation that wasn't available during the first assessment
2. Ask the assessor to review specific items — if you believe a domain was scored incorrectly, you can challenge it with evidence
3. Escalate through NASC — if a reassessment doesn't change the outcome, contact the NASC supervisor and request a clinical review

Don't accept an under-allocation silently. The assessment is clinical, not bureaucratic — new evidence can change the outcome.

For a structured interRAI preparation kit — including the five-day diary template, the carer distress self-audit, and a guide to translating daily struggles into clinical language — the Home and Community Support Services guide covers the entire assessment process.

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