BSN Tracker

Assessment Tool: ISAR

The Identification of Seniors At Risk (ISAR) is a brief, validated screening tool used in emergency and acute care settings to identify older adults (aged ≥ 65) at elevated risk for functional decline, repeat emergency visits, prolonged hospitalisation, or adverse outcomes after discharge. Six yes/no items address pre-illness dependence, increased care needs since illness onset, recent hospitalisation, vision problems, memory problems, and polypharmacy. A score of ≥ 2 is a positive screen, triggering comprehensive geriatric assessment and proactive discharge planning. Vague presentations or apparently minor complaints in older adults frequently mask broader vulnerability — the ISAR makes that vulnerability visible before discharge decisions are made.

ISAR — Identification of Seniors At Risk

A validated six-item yes/no screening tool for identifying older adults at risk for functional decline, repeat emergency visits, hospitalization, or adverse outcomes after discharge from emergency or acute care. Scores range from 0 to 6; a score of ≥ 2 is generally considered a positive screen for elevated risk and indicates the need for a comprehensive geriatric assessment and discharge planning intervention.

Score interpretation

0–1

Low risk — routine discharge planning

≥ 2

Elevated risk — comprehensive assessment recommended

Each "Yes" answer scores 1 point. The ISAR is administered to patients aged ≥ 65 in emergency or acute care settings. A positive screen warrants referral for geriatric evaluation and social work consultation.

1. Before this illness or injury, did you need someone to help you on a regular basis?
2. Since this illness or injury, have you needed more help than usual to take care of yourself?
3. Have you been hospitalized for one or more nights during the past 6 months (excluding your visit today)?
4. In general, do you see well? (Answer No if you have problems with your vision) (No = 1 point)
5. In general, do you have serious problems with your memory?
6. Do you take more than 3 different medications every day?