Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly

CAM

 Confusion Assessment Method

Purpose : Test for delirium


Admin time : 10 min


User Friendly :  High


Administered by : Healthcare professional

 

Content : The original 9-item CAM identifies delirium using the following criteria: acute onset and fluctuation, inattention, disorganized thinking, altered level of consciousness, disorientation, memory impairment, perceptual disturbances, psychomotor agitation or retardation, and altered sleep-wake cycle.

 

Author :  Inouye SK, 1990

Copyright : Hospital Elder Life Program

Free to use for clinical purposes.

Any replication of the CAM or publication must include the following copyright acknowledgment.
“Confusion Assessment Method. © 1988, 2003, Hospital Elder Life Program. All rights reserved. Adapted from: Inouye SK et al. Ann Intern Med. 1990; 113:941-8.”

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CAM

bCAM

brief Confusion Assessment Method

Purpose : Test for delirium


Admin time : 5 min


User Friendly :  High


Administered by : Healthcare professional

 

Content : The brief CAM version is a quicker assessment, which eliminates the last 5 components and only includes the first 4 from the original algorithm. The short version is what is most commonly used in clinical practice.

 

Author :  Inouye SK, 1996

Copyright : Hospital Elder Life Program

Free to use for clinical purposes.

Any replication of the CAM or publication must include the following copyright acknowledgment.

“Confusion Assessment Method. © 1988, 2003, Hospital Elder Life Program. All rights reserved. Adapted from: Inouye SK et al. Ann Intern Med. 1990; 113:941-8.”

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bCAM

famCAM

family Confusion Assessment Method

Purpose : Test for delirium


Admin time : 5-10 min


User Friendly :  High


Administered by : Healthcare professional or carer assisted

 

Content : The Family Confusion Assessment Method (FAM-CAM) is an informant-based variation of the CAM in which a family member or caregiver assesses the patient's mental and cognitive status using a series of questions.

Clinicians ask family members or caregivers these questions in person, by telephone, or electronically.They will ask about the patient’s recent mental and cognitive status, sleeping patterns, and abnormal actions or dialogue.

The FAM-CAM can be used in both clinical and research settings, where it can be useful for facilitating and educating caregivers about possible acute changes in mental status, and early signs of cognitive changes in older individuals.

It also may be used in clinical settings where delirium cannot be readily assessed by health care professionals (e.g., hospitals, ICUs, presurgery or postsurgery, postdischarge, or extended care settings).

 

Author :  Inouye SK, 1999

Copyright : Hospital Elder Life Program

Free to use for clinical purposes.

Any replication of the CAM or publication must include the following copyright acknowledgment.

“Confusion Assessment Method. © 1988, 2003, Hospital Elder Life Program. All rights reserved. Adapted from: Inouye SK et al. Ann Intern Med. 1990; 113:941-8.”

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famCAM for clinician

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famCAM for caregiver

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famCAM for caregiver - scoring

CAM

 

Advantages:

  • Free to use.

  • Extensively validated.

  • Adaptation available for different clinical settings and users.

  • Readily available training and instructions for use.

 

Disadvantages: 

  • Lack of training leads to improper use and results.

  • The danger of inaccurate assessment of consciousness level and inattention is that hypoactive delirium, which accounts for approximately 1/3 of delirium cases, is easily missed. Hypoactive delirium is associated with worse clinical outcomes, and its under recognition may prevent patients from receiving timely treatment.

Accuracy : 

sensitivity 94% and specificity 89% (Wei LA, 2008)

This Tool is used in Delirium

Back To : Delirium

confused old woman in bed

Delirium is one of 4 sub-domains of the  

Psychological Assessment

Back To : Psychological Assessment

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The Psychological Assessment is one of 8 domains of the

Comprehensive Geriatric Assessment (CGA)

Back To : Comprehensive Geriatric Assessment