Portuguese version
Martins, S., Simões, M. R., & Fernandes, L. (2013). Portuguese Version of the Family Confusion Assessment Method (FAM-CAM): Preliminary Results. 8th Annual Meeting of the European Delirium Association (EDA), 20-21 September, Belgium.
Original version
Inouye S.K., Puelle M.R., Saczynski J.S. & Steis M.R. (2011). The Family Confusion Assessment Method (FAM-CAM): Instrument and Training Manual. Hospital Elder Life Program, LLC.
Theoretical background
Information and observations from family members and/or caregivers about mental status changes in older people can be of significant help in early detection of delirium (or acute confusional state), as well as monitoring and providing more appropriate intervention/treatment in this clinical condition.
The Family Confusion Assessment Method (FAM-CAM; Inouye et al., 2011) was constructed, in this context, from the original instrument Confusion Assessment Method (CAM; Inouye et al., 1990), as a method of detecting delirium, to be completed based on information from family members and/or caregivers. This instrument can be administered to a family member/caregiver, in person, by telephone, or by email, allowing the evaluation of these cases to be extended to contexts where delirium may not be so easily examined by health professionals.
The FAM-CAM is intended to assist in the detection of this clinical condition and should therefore not be used as an independent diagnostic tool. Thus, the diagnosis of delirium supposes the joint resource of the FAM-CAM and the CAM and confirmation by specialized clinicians (Inouye et al., 2011).
Description
Assessment Domain: Delirium.
Type of Instrument: Rating scale.
Application: Individual, 5 minutes.
Population: Adult.
Dimensions
The FAM-CAM assesses the presence of eight features of delirium: 1. Acute onset, 2. Inattention, 3. Disorganized thinking, 4. Altered level of consciousness, 5. Disorientation, 6. Perceptual disturbances, 7. Psychomotor agitation and 9. Fluctuating course. It also included three additional items, for the detailed recording of proven alterations (item 8), identification of their onset (item 10), as well as their clinical course (item 11).
The FAM-CAM is considered positive if the following criteria are present: acute onset or fluctuating course and inattention and also disorganized thinking or altered level of consciousness.
Studies
FAM-CAM has several studies in the Portuguese population: translation and adaptation study (Martins, Simões, & Fernandes, 2013); validation study based on a sample of 40 family members/caregivers of hospitalized elderly adults, which allowed us to conclude, namely, the existence of good specificity and sensitivity (Martins et al., 2014b; Fernandes et al, 2015b).
The Portuguese investigations with FAM-CAM were carried out within the scope of the doctoral thesis (Title: Confusion Assessment Method (CAM): Adaptation, validation for the Portuguese population), by Sónia Patrícia Vilar Martins (FCT PhD Scholarship - SFRH /BD/63154/2009/Psychology), student of the Doctoral Program in Gerontology and Geriatrics, at the Abel Salazar Institute of Biomedical Sciences, University of Porto.
The use of CAM and FAM-CAM requires prior training and training of interviewers.
References
- Fernandes, L., Martins, S., & Simões, M.R. (2015b). Family Confusion Assessment Method (FAM-CAM). In Mário R. Simões, Isabel Santana e Grupo de Estudos de Envelhecimento Cerebral e Demência (Eds.), Escalas e Testes na Demência (3ª. edição; pp. 164-169) [Scales and Tests in Dementia, 3rd edition]. Novartis.
- Inouye S.K., Puelle M.R., Saczynski J.S. & Steis M.R. (2011). The Family Confusion Assessment Method (FAM-CAM): Instrument and Training Manual. Hospital Elder Life Program, LLC.
- Martins, S., Conceição, F., Paiva, J.A., Simões, M. R., & Fernandes, L. (2014b). Delirium Recognition by Family: European Portuguese Validation Study of the Family Confusion Assessment Method (FAM-CAM). Journal of the American Geriatric Society, 62(9), 1748-1752. https://doi.org/10.1111/jgs. 12973
- Martins, S., Simões, M. R., & Fernandes, L. (2013). Portuguese Version of the Family Confusion Assessment Method (FAM-CAM): Preliminary Results. 8th Annual Meeting of the European Delirium Association (EDA), 20-21 September, Belgium.