MEDSAIL
Making and Executing Decisions for Safe and Independent Living
A brief, scenario-based screening tool used by appropriately trained health and social service professionals to examine how an older adult reasons through everyday challenges.
Learning order
Follow the reading sequence from context, to administration, to scoring detail.
Example conversation
Follow the exchange from the scenario through each question and response. The example shows the structure of the conversation, not an answer to coach.
Scenario
You run out of a medication that you take regularly.
How to begin: Present the scenario consistently and without adding advice.
Administrator
Please tell me in your own words what I just said.
What this checks: Understanding is an unscored stop-or-continue check.
Example respondent
I have no medication left, and it is something I usually take every day.
Administrator
Would this be a problem for you? Why or why not?
What this checks: Listen for whether the person appreciates the personal impact.
Example respondent
Yes. Missing it could affect my health, and I would want to deal with it before the next dose.
Administrator
What would you do in this scenario?
What this checks: Listen for a clear choice or plan.
Ask neutral follow-up questions
When an answer is unclear, ask for more detail without suggesting what the person should say.
- 1
Listen for a gap
If the answer is vague or incomplete, notice what detail is still missing.
- 2
Ask one neutral question
Invite more detail without suggesting a solution or preferred answer.
“Can you be more specific?”
- 3
Move on
Stop when the reasoning is clear or the person has no more detail to add.
One simple example
The respondent says, “I would call someone.”
Ask
“Can you be more specific?”
This asks for detail without suggesting an answer.
Avoid
“Would you call your daughter?”
This introduces a solution the respondent did not provide.