Checklist Trouble remembering significant past (RMBPC) events Forgetting what day it is () Sleep disturbances (waking you or Administration and Use this citation.1 No Behavioral other family members up at night). scoring instructions 23 other permissions symptoms Resists bathing or showering. are included on the () required. Insists on driving. instrument. (continued) Evaluation Instrument Details (continued) Instrument How and citation many Domain links items Sample item(s) Instructions, scoring Permissions [In relation to each behavioral symptom, is the symptom present? If yes: frequency, severity, and how much distress it causes.] Example: Agitation/aggression Does the patient have periods when Behavioral 12 he/she refuses to cooperate or won’t let symptoms () people help him/her? Is he/she hard to handle? Does the patient shout or curse angrily? Does the patient slam doors, kick furniture, throw things? Burden Scale I often feel physically exhausted. Point values for each item for Family My health is affected by the care are included on the scale. The BSFC-s is free of Caregivers situation. Scores of 0-4 = low Burden 10 charge for (BSFC-s) I feel torn between the demands of burden; 5-14 = moderate commercial my environment (such as family) and burden; 15-30 = high (Graessel et the demands of the care. burden. al.)
Checklist (RMBPC) () Trouble remembering significant past events Forgetting what day it is Behavioral symptoms () 23 Sleep disturbances (waking you or other family members up at night). Resists bathing or showering. Insists on driving. Administration and scoring instructions are included on the instrument. Use this citation.1 No other permissions required. (continued) Evaluation Instrument Details (continued) Domain Instrument and citation links How many items Sample item(s) Instructions, scoring Permissions Behavioral symptoms () 12 [In relation to each behavioral symptom, is the symptom present? If yes: frequency, severity, and how much distress it causes.] Example: Agitation/aggression Does the patient have periods when he/she refuses to cooperate or won’t let people help him/her? Is he/she hard to handle? Does the patient shout or curse angrily? Does the patient slam doors, kick furniture, throw things? Burden Burden Scale for Family Caregivers (BSFC-s) (Graessel et al.) 10 I often feel physically exhausted. My health is affected by the care situation. I feel torn between the demands of my environment (such as family) and the demands of the care. Point values for each item are included on the scale. Scores of 0-4 = low burden; 5-14 = moderate burden; 15-30 = high burden. The BSFC-s is free of charge for commercial
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