Symptom Assessment Scale (SAS) (169kb docx) |
Measure severity of distress of the following symptoms: (1) Difficulty sleeping; (2) Appetite problems; (3) Nausea; (4) Bowel problems; (5) Breathing problems; (6) Fatigue; and (7) Pain. |
Yes |
Yes |
Yes |
Modified Borg Scale (mBORG) (182kb pdf) |
Assess difficulty of breathing in a person able to communicate verbally or point. |
Yes |
Yes |
Yes |
Mini-Nutritional Assessment Short-Form (MNA®-SF)(68.5kb pdf) |
Identify an older person who is malnourished or at risk of malnutrition. |
Yes |
Yes |
Yes |
Modified Resident's Verbal Brief Pain Inventory (M-RVBPI) (112kb pdf) |
Assess pain multidimensionally in a person able to communicate. This can be undertaken weekly or at longer intervals. |
Yes |
Yes |
Yes |
Numerical Rating Scale for pain (NRS) (31kb pdf) |
Assess pain intensity in a person able to communicate verbally or point. |
Yes |
Yes |
Yes |
Abbey Pain Scale (38.2kb pdf) |
Measure pain in a person with dementia who cannot communicate verbally. |
Yes |
Yes |
Yes |
Verbal Descriptor Scale (Pain Thermometer) (105kb pdf) |
Assess pain intensity in a person able communicate verbally or point, including a person with moderate to severe cognitive impairment. |
Yes |
Yes |
Yes |
Confusion Assessment Method (CAM) - Shortened version (2MB pdf) |
Identify a person with delirium. |
Yes |
Yes |
Yes |
Kessler Psychological Distress Scale (K10) (64kb pdf) |
Measure psychological distress. |
Yes |
Yes |
Use Cornell Scale for Depression |
Modified Cornell Scale for Depression (CSD) – available in the ACFI Assessment Pack (CSD pages 10-13 and pages 27-40; 492kb pdf). |
Assess depression in a person with or without cognitive impairment. |
Use K10 |
Use K10 |
Yes |
NAT-CC – Needs Assessment Tool for Caregivers (148kb pdf) |
Identify areas of concern for someone providing care to a person living with a chronic condition. |
Yes |
Yes |
N.A |