Carer Appraisal Scale - A Carer-Based Assessment of Patient Functioning

Measurement of patient outcomes is an integral part of mental health service evaluation, as well as guiding clinical practice to ensure best outcomes for patients. Despite there existing numerous tools for quantifying patient functioning based on clinician assessments or self-reports, there is a serious paucity of tools available for the carers of patients to appraise their functioning.

Collateral information is well recognised as being integral for assessments of patients, but there are very few structured systems for assessing patients based on the perceptions of carers. This is despite the usually greater lengths of time carers spend with patients than clinicians.

Dr Neil Jeyasingam describes a tool developed for use in a community aged care psychiatric service, which involves four sections:

• a global impression of patient progress,
• a scorable checklist of patient functioning in multiple domains,
• a qualitative section for identifying the most pressing concerns from the carer's perspective, and
• an open-ended feedback on treatment to date.

In this pilot study, Dr Jeyasingam validated the tool against multiple well-recognised clinician assessment tools, and found good correlation in most domains. In addition, there was extensive positive feedback from carers themselves regarding our use of this tool in regular clinical practice.

Dr Jeyasingam feels this tool has the potential for use in other community aged care psychiatric services, as it provides a framework for communication of concerns, assists in prioritising care and adds value to clinician treatment plans, as well as providing another dimension to assessment of the patient.

Practical implications of its use, limitations and potential for modifications to suit other settings will be also discussed.

Dr Neil Jeyasingam, Old Age Psychiatrist, Northern Sydney / Central Coast Area Health Service will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.