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. Author manuscript; available in PMC: 2009 Aug 6.
Published in final edited form as: J Am Geriatr Soc. 2009 Apr 21;57(6):1064–1072. doi: 10.1111/j.1532-5415.2009.02260.x

Table 2.

Overview of the Resources for Enhancing Alzheimer’s Caregiver Health II (REACH II) 16-item Risk Appraisal Measure (RAM)a

Domain Definition of Domain RAM items Example of Treatment Strategies
Self-Care and Healthy Behaviors Caregiver’s physical well- being and self-care behaviors.

  • Caregiver has trouble sleeping

  • Caregiver’s rating of physical health

  • Provide educational materials on self-care; Provide instruction on healthy- behaviors; Referral to appropriate medical resources (e.g., nutritionists).
Patient Problem Behaviors Difficulties in the management of patient ADL/IADL and behavioral problems.

  • Caregiver has information on symptoms of dementia

  • Caregiver feels stress when trying to help patient with daily activities

  • Provide educational materials on dementia and managing problem behaviors; Engage in problem solving exercises; Provide a written prescription of strategies to manage behaviors.
Burden Feeling stressed due to caregiving responsibilities Feels good as a result of caregiving

  • CG feels stress trying to meet other responsibilities

  • CG feels strain around patient

  • Caregiver feels good as a result of caregiving

  • Provide educational materials on stress and stress management techniques; management techniques (e.g., breathing exercises, stretching).
Depression Feeling depressed or sad.

  • Caregiver felt depressed in the last week

  • Provide information and instruction on strategies for engaging in pleasant events and mood management; referral to appropriate healthcare specialist (e.g., counselor).
Social Support Satisfaction with support from friends or family

  • Satisfaction with help from friends

  • Satisfaction with support from others

  • Provide information on community resources; Provide education about the importance of social support and communication skills; Referral to a support group.
Safety Being at risk due to caregiver’s behavior Being at risk as a result of patient impairment

  • Feel like yelling at CR

  • Refrain from hitting Cr

  • Dangerous objects are in the home

  • Patient wanders

  • Patient drives

  • Able to leave patient alone

  • Provide education and instruction on stress and anger management techniques;

  • Remove dangerous objects from home; Enroll patient in“Safe Return” program of the Alzheimer’s Association; File report with local DMV office.
a

The RAM is available from the authors