Instrument How and citation many Domain links items Sample questions Instructions, scoring Permissions Risk/ Caregiver 53 Do you or a family member have Administration Credit the developers by Safety Risk durable power of attorney or instructions are using the complete Appraisal guardianship for [care recipient]? included on the citation. No other Questionnaire Do you ever leave [care recipient] instrument. permissions are required. (REACH II) alone or unsupervised in the p. 68-73 home? Does [care recipient] drive? () Risk/ Dementia 13 Respondent rates the person’s No instructions No special permissions Safety Crisis to level of risk on several domains provided. Consult with required. Thriving such as food security, in-home an evaluator for Scale* care, and falls risk. Example - appropriate use. Falls Risk: () Falls 2 or more times in past month, with injury, home is unsafe. Home unsafe. Fall without injury, or no fall in past 3 months. Home is safe. Fall within three to five months, no injury. Fall risk factors exist. No falls in past 6 months, home is safe, no fall risk factors. No falls in past 12 months, gait stable, active, safe home. (continued) Evaluation Instrument Details (continued) Instruments indicated with an asterisk (*) are available upon request from the National Alzheimer’s and Dementia Resource Center
Domain Instrument and citation links How many items Sample questions Instructions, scoring Permissions Risk/ Safety Caregiver Risk Appraisal Questionnaire (REACH II) p. 68-73 () 53 Do you or a family member have durable power of attorney or guardianship for [care recipient]? Do you ever leave [care recipient] alone or unsupervised in the home? Does [care recipient] drive? Administration instructions are included on the instrument. Credit the developers by using the complete citation. No other permissions are required. Risk/ Safety Dementia Crisis to Thriving Scale* () 13 Respondent rates the person’s level of risk on several domains such as food security, in-home care, and falls risk. Example - Falls Risk: Falls 2 or more times in past month, with injury, home is unsafe. Home unsafe. Fall without injury, or no fall in past 3 months. Home is safe. Fall within three to five months, no injury. Fall risk factors exist. No falls in past 6 months, home is safe, no fall risk factors. No falls in past 12 months, gait stable, active, safe home. No instructions provided. Consult with an evaluator for appropriate use. No special permissions required. (continued) Evaluation Instrument Details (continued) Instruments indicated with an asterisk (*) are available upon request from the National Alzheimer’s and Dementia Resource Center
2018EvalMeasuresResourceList%20508_0.docx