What Is an interRAI Assessment?
If you have started looking into care for a parent in New Zealand, you will run into the words “needs assessment” and “interRAI” very quickly. Almost nothing in the funded care system happens without one.
This guide explains what the assessment is, who carries it out, how to arrange one, what happens on the day, and how to prepare so the outcome reflects what your parent’s life is actually like.
The short version
An interRAI assessment is a standardised clinical assessment used across New Zealand to work out what support an older person needs. It is arranged through your local NASC service, it is free, and your parent’s GP can start the referral.
The assessment determines what level of support your parent is eligible for, whether that is help at home or a move into residential care. Without it, publicly funded care is not available.
Why this matters more than families expect
The assessment is not a formality. It is the gate.
It determines whether your parent qualifies for funded home support. It determines whether they meet the threshold for residential care and at what level. It shapes what a facility can offer them and what the government will contribute.
Families sometimes discover this late, after weeks of researching rest homes, and find they cannot move forward until an assessment has happened. If a move to care is on the horizon, starting the assessment process early is one of the most useful things you can do.
What interRAI actually is
interRAI is the assessment tool itself, a structured set of questions and observations used consistently across the country. It is not a New Zealand invention. It is used internationally, and New Zealand adopted it so that assessments are consistent from one region to another rather than depending on the judgement of whoever happens to visit.
In practice, the assessor works through a wide range of areas, including:
How your parent manages daily tasks such as dressing, bathing, cooking, and getting around
Memory, thinking, and decision making
Mood and wellbeing
Physical health, medications, and pain
Continence
Safety at home, including falls
What support is already in place from family, friends, and services
The answers build a picture that produces a recommended level of support.
Who carries it out
Assessments are arranged and carried out through NASC, which stands for Needs Assessment and Service Coordination. NASC services operate regionally and sit under Health New Zealand.
Your NASC will assign an assessor, usually a registered nurse, occupational therapist, or social worker trained in the interRAI tool. The same organisation also coordinates services after the assessment, so your NASC coordinator often becomes your ongoing point of contact.
How to arrange one
There are two common routes.
Through the GP. This is the most common path. Your parent’s GP can make a referral to the local NASC. If you are worried about a parent and not sure where to start, a GP appointment is a reasonable first step, and it has the added benefit that a doctor may spot health issues contributing to the decline.
Directly to NASC. You can also contact your regional NASC service yourself. Search for your region plus “NASC” to find the right service, or ask the GP practice for the contact details.
The assessment is free. There is no charge to the family for the assessment itself.
What happens on the day
The assessment usually takes place where your parent lives, which matters, because the assessor can see the actual environment: the stairs, the bathroom, the state of the kitchen, whether there is food in the fridge.
Expect a conversation rather than a test. The assessor will talk with your parent, ask questions, and observe. Family members can usually be present, and it is worth being there if you can.
Plan for it to take a while. [VERIFY typical duration with your local NASC before publishing a specific time.]
The problem nobody warns families about
Older people very often perform well during an assessment.
There are understandable reasons. Your parent may be proud, may be frightened of losing independence, may genuinely not remember the bad days, or may simply rise to the occasion in front of a visitor. It is common for someone who has been struggling for months to present as capable for an hour.
The result is an assessment that reflects the best version of a person rather than the typical one, and a support package that does not match real life.
Three things help:
Be present if you can. Not to speak over your parent, but so the assessor hears more than one account.
Bring specifics, not impressions. “She has fallen twice since Christmas, once in the bathroom” is more useful than “she has been a bit unsteady.” Write things down in the weeks beforehand: incidents, missed medications, meals not eaten, nights that went badly.
Say the difficult things out loud. This is uncomfortable, particularly with your parent in the room. But an assessor can only work with what they are told. If continence, confusion, or safety are issues, they need to be named. If you cannot say them in front of your parent, ask the assessor whether you can speak with them separately.
Preparing for the assessment
Useful things to have ready:
A current list of medications, including anything over the counter
Names and contact details for the GP and any specialists
A note of recent hospital admissions or falls
A record of what support is already happening, including what you and other family are doing
Any questions you want to ask about services and next steps
What the assessment determines
The outcome sets the level of support your parent is eligible for. Broadly this falls into two paths.
Support at home. A package of home based support such as personal care, household help, or nursing visits, coordinated through NASC. See our guide to home care in New Zealand
Residential care. If needs meet the threshold, the assessment specifies the level of care: rest home, hospital, dementia, or psychogeriatric. Our rest homes and residential care pageexplains what each level involves.
One point families find frustrating: you cannot choose a higher level of care than the one assessed. The assessment drives the decision, not family preference and not the facility’s availability. If you think the outcome does not reflect your parent’s situation, say so and ask about a review rather than working around it.
What happens after
Your NASC coordinator will talk through the outcome and what services are available. If residential care is the outcome, the family then chooses a facility, and a separate financial means assessment through Work and Income determines who pays for what. That is a different process entirely, and we cover it in our guides to rest home costsand the Residential Care Subsidy.
Needs change. Assessments can be reviewed if your parent’s situation shifts, and asking for a reassessment is a normal part of the process rather than an imposition.
If this is happening in a hurry
Sometimes the assessment is not something you plan for. A parent goes into hospital after a fall and the discharge team says they cannot go home.
In that situation the hospital works with NASC to arrange assessment and placement, and the process moves faster than it would otherwise. Ask to speak with the hospital’s discharge planner and the NASC coordinator early, and ask what your options are for short term placement while the family decides, rather than being pushed into a permanent choice in a few days.
Frequently asked questions
What does interRAI stand for?
interRAI is the name of the international organisation and the family of assessment tools it developed. In New Zealand the term is used to describe the standardised needs assessment used across the country for older people.
Does an interRAI assessment cost anything?
No. The needs assessment is free.
How do I arrange an interRAI assessment for my parent?
Ask your parent’s GP to make a referral to your local NASC service, or contact the NASC in your region directly. Search your region plus “NASC” to find the right service.
Can my parent refuse an assessment?
Yes. An assessment cannot be forced on a competent adult. If your parent is refusing help altogether, our guide on what happens when an elderly parent refuses help may be more useful as a starting point than pushing for an assessment.
Can family be present during the assessment?
Usually yes, and it is often helpful. If there are things you need to tell the assessor that you cannot say in front of your parent, ask whether you can speak with them separately.
What if we disagree with the outcome?
Raise it with your NASC coordinator and ask about a review. Assessments can also be redone if circumstances change.
Is the interRAI assessment the same as the means assessment?
No, and this catches families out. The interRAI needs assessment determines what care your parent needs. The financial means assessment, carried out by Work and Income, determines who pays for it. Both are usually required for funded residential care.