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.”
CAM
CAM-short
Confusion Assessment Method - short
Purpose : Test for delirium
Admin time : 5 min
User Friendly : High
Administered by : Healthcare professional
Content : The CAM-short 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.”
CAM-short
bCAM
brief Confusion Assessment Method
Purpose : Test for delirium
Admin time : 5 min
User Friendly : High
Administered by : Healthcare professional
Content : The bCAM is an adaptation of the original Confusion Assessment Method (CAM), which was initially created by Dr. Sharon K. Inouye in 1990.
The bCAM was specifically modified to provide a rapid, bedside delirium screening tool (taking less than 2 minutes) for emergency and hospital ward settings.
The brief CAM version focuses on 4 core delirium features: acute onset/fluctuating course, inattention, altered level of consciousness, and disorganized thinking.
Author : The Brief Confusion Assessment Method (bCAM) was developed and validated by a research team led by Dr. Jin H. Han and Dr. E. Wesley Ely at Vanderbilt University Medical Center in 2013.
Copyright : Copyright © 2012. Vanderbilt University.
The Brief Confusion Assessment Method (bCAM) is adapted from: Ely EW, et al. JAMA. 2001; 286: 2703-2710. Confusion Assessment Method for the Intensive Care Unit. Copyright © 2002, Vanderbilt University.
Inouye SK, et al. Ann Intern Med. 1990; 113: 941-948. Confusion Assessment Method. Copyright © 2003, Hospital Elder Life Program, LLC.
Not to be reproduced without permission.
bCAM - flowsheet, manual, calculator
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.”
famCAM for clinician
famCAM for caregiver
famCAM for caregiver - scoring
CAM
Advantages:
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Free to use.
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Extensively validated.
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Adaptation available for different clinical settings and users.
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Readily available training and instructions for use.
Disadvantages:
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Lack of training leads to improper use and results.
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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
Delirium is one of 4 sub-domains of the
Psychological Assessment
Back To : Psychological Assessment
The Psychological Assessment is one of 8 domains of the
Comprehensive Geriatric Assessment (CGA)
Back To : Comprehensive Geriatric Assessment
