4. Irritability, easily annoyed, short tempered Interviewing staff or other informant: Interviewing the care recipient or observation: Has X/ she/ he been irritable short-tempered, Observe care recipient during interview – easily annoyed or unusually impatient in the last Have you been feeling irritable, easily annoyed or – week? short-tempered in the last week? Can you give me an example? Can you give me an example? Does this happen occasionally or often? Does this happen occasionally or often? How much does it interfere with her/ his everyday How much does it interfere with your everyday life? life? Staff: Interview Other: Observation Notes: Score unable to score = a absent = 0 minor interference with everyday life and/ or symptoms occur occasionally = mild = 1 major interference with everyday life and symptoms occur often = severe = 2 5-8: behavioural disturbance Q’s 5. Agitation (physical restlessness, hand wringing, hair pulling) Interviewing staff or other informant: Interviewing the care recipient or observation: Has X/ she/ he been so restless in the last week that Observe the care recipient been unable to sit still for even an hour? Have you been so restless in the last week that you they’ve Has she/ he done things like pacing up and down, have been unable to sit still for an hour? wringing their hands or sighing? Can you give me an example? Can you give me an example? Does this happen occasionally or often? Does this happen occasionally or often? How much does it interfere with your everyday life? How much does it interfere with her/ his everyday life? Staff: Interview Other: Observation Notes: Score unable to score = a absent = 0 minor interference with everyday life and/ or symptoms occur occasionally = mild = 1 major interference with everyday life and symptoms occur often = severe = 2
4. Irritability, easily annoyed, short tempered Interviewing staff or other informant: Has X/ she/ he been irritable – short-tempered, easily annoyed or unusually impatient – in the last week? Can you give me an example? Does this happen occasionally or often? How much does it interfere with her/ his everyday life? Interviewing the care recipient or observation: Observe care recipient during interview Have you been feeling irritable, easily annoyed or short-tempered in the last week? Can you give me an example? Does this happen occasionally or often? How much does it interfere with your everyday life? Staff: Interview Other: Observation Notes: Score unable to score = a absent = 0 minor interference with everyday life and/ or symptoms occur occasionally = mild = 1 major interference with everyday life and symptoms occur often = severe = 2 Q’s 5-8: behavioural disturbance 5. Agitation (physical restlessness, hand wringing, hair pulling) Interviewing staff or other informant: Has X/ she/ he been so restless in the last week that they’ve been unable to sit still for even an hour? Has she/ he done things like pacing up and down, wringing their hands or sighing? Can you give me an example? Does this happen occasionally or often? How much does it interfere with her/ his everyday life? Interviewing the care recipient or observation: Observe the care recipient Have you been so restless in the last week that you have been unable to sit still for an hour? Can you give me an example? Does this happen occasionally or often? How much does it interfere with your everyday life? Staff: Interview Other: Observation Notes: Score unable to score = a absent = 0 minor interference with everyday life and/ or symptoms occur occasionally = mild = 1 major interference with everyday life and symptoms occur often = severe = 2
acfi_assessment_pack_2017.docx