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Psychometric Evaluation of the Functional Capacity Card Sort: Measuring Caregiver Appraisal of Functional Capacity in Persons with Dementia



Caregivers play a vital role in the safety and well-being of people with dementia

  • Majority of people with dementia live at home, are cared for by families or close friends/neighbors, and require supervision or assistance with daily activities

  • 80% of care provided in the home is delivered by unpaid caregivers (Alzheimer’s Association, 2013, Family Caregiver Alliance, 2006)

    Functional capacity in the person with dementia is usually assessed by caregiver interview

  • Caregiver report is an important proxy measure in dementia care as the person with the cognitive impairment tends to overestimate function (Karagiozis et al., 1998; Kiyak, et al., 1994)

    Caregiver appraisal of functional capacity is an essential element to the day to day responsibilities of caregiving

  • Cognitive process that caregivers use to judge functional capacity of the person with dementia

    • Serves as a mediator for the actions caregivers take in providing daily care (amount and type of oversight; modifications to the home)

  • Has consequences for safety and well-being of the person with dementia

    Caregivers often misjudge functional ability of the person with dementia

    • Caregivers overestimate and underestimate function (Karagiozis et al., 1998; Zanetti, et al., 1999; Argṻelles, et al., 2001; Loewenstein et al., 2001; Davis, et al, 2006)

      Caregiver scales have been developed to correspond with direct assessment to determine concordance status

  • There are inconsistencies between certain items, which make it difficult to draw conclusions about caregiver accuracy

  • The Functional Capacity Card Sort (FCCS) was developed to measure and interpret caregiver appraisal of functional capacity by comparing the caregiver rating to the score on the standardized Allen Diagnostic Module-2 (Earhart, 2006).