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FAM-CAM: Family Confusion Assessment Method

2012

FAM-CAM is an informant-completed CAM-family case-finding measure that uses a family member's or caregiver's knowledge of recent change.

At a glance

Purpose
Episodic assessment
Population
Adult
Setting
General / acute hospital, Long-term / care home
Time
variable
Items
11
Score or threshold
CAM-family informant classification; see the authorised form.

Format: An 11-item informant measure covering recent change and CAM-related clinical domains. The questions, response options, weights and decision rule are not reproduced here.

  • Strengths: Family-informant detection incl. with pre-existing impairment
  • Limitations: Small validation; not standalone diagnosis

CAM usually means the four-feature short form; the long form has ten items. Check which form and supporting assessment the study used. Short and long CAM explained.

Primary validation papers

8 identified diagnostic-accuracy papers

Other forms of validation are described in the evidence section. What is counted?

Large-scale clinical implementation

None identified in the scoped review.

None identified in the selected profile sources and the Penfold general-hospital review. This is not a completed search of all settings or later papers.

Training and instructions

  • FAM-CAM training manual. Developer resource page with the instrument-specific manual. Check the current version and reuse terms.
  • FAM-CAM form. Public instrument material checked on 5 September 2026. Follow the source’s version and permission conditions.
  • FAM-CAM manual or instructions. Public manual or instructions checked on 5 September 2026. Follow the source’s version and permission conditions.
Start here

Tool and original sources

Copyright restrictions mean that a copy of FAM-CAM cannot be provided on this website. Use the official access page below. Google Images may also help you see what the form looks like.

Open the official tool page ↗ Search Google Images ↗

Original and selected diagnostic-accuracy papers

  • Original paperSteis MR, Evans L, Hirschman KB, Hanlon A, Fick DM, Flanagan N, et al. Screening for delirium using family caregivers: convergent validity of the Family Confusion Assessment Method and interviewer-rated Confusion Assessment Method. Journal of the American Geriatrics Society. 2012;60(11):2121-6. doi: 10.1111/j.1532-5415.2012.04200.x. PMID: 23039310.

    This paper reports the original validation of FAM-CAM. It is the main source for the method, its intended use and the evidence available at publication.

    Open PubMed ↗
  • Selected diagnostic-accuracy studyFiest KM, Krewulak KD, Ely EW, Davidson JE, Ismail Z, Sept BG, et al. Partnering With Family Members to Detect Delirium in Critically Ill Patients. Critical care medicine. 2020;48(7):954-961. doi: 10.1097/CCM.0000000000004367. PMID: 32332281.

    This diagnostic-accuracy study evaluated FAM-CAM in large tertiary-care academic adult ICU against an independent DSM-5 clinical assessment. It reported sensitivity of 54.1% and specificity of 76.8% in 147 ICU patient-family dyads.

    Open PubMed ↗
  • Selected diagnostic-accuracy studyMartins S, Conceição F, Paiva JA, Simões MR, Fernandes L. Delirium recognition by family: European Portuguese validation study of the family confusion assessment method. Journal of the American Geriatrics Society. 2014;62(9):1748-52. doi: 10.1111/jgs.12973. PMID: 25039562.

    This diagnostic-accuracy study evaluated FAM-CAM in intermediate-care unit in a Portuguese tertiary hospital against a DSM-IV-TR clinical assessment. It reported sensitivity of 75% and specificity of 91% in 40 family members or caregivers of older hospitalised adults.

    Open PubMed ↗
Multiple DTA studies identifiedCore instrument family
Classification

Classification

Episodic assessmentInformant tools

A tool may belong to more than one category. Select a linked category to see other relevant profiles.

Evidence

Diagnostic-accuracy evidenceMultiple DTA studies identified

Reported sensitivity and specificity

88%
Sensitivity
98%
Specificity

Convergent validity, n=52 dyads.

More evidence and citation details
Full name
Family Confusion Assessment Method
Also known as
FAM-CAM
Evidence summary
multi
Diagnostic-accuracy evaluations
8
Reference standard
Interviewer CAM
Reliability
κ 0.85
Citation
Steis MR, Evans L, Hirschman KB, Hanlon A, Fick DM, Flanagan N, Inouye SK Screening for delirium using family caregivers: convergent validity of the Family Confusion Assessment Method and interviewer-rated Confusion Assessment Method Journal of the American Geriatrics Society. 2012;60(11):2121-6. PMID 23039310
Download RIS ↗ Download BibTeX ↗

Primary validation studies

Distinct primary publications from the current diagnostic-accuracy audit. Reviews and repeated evaluations within one paper are not counted again. Overlapping cohorts have not all been reconciled. Read the counting rules and limitations.

Open 8 identified papers
  1. Steis MR, Evans L, Hirschman KB, Hanlon A, Fick DM, Flanagan N, Inouye SK (2012). Screening for delirium using family caregivers: convergent validity of the Family Confusion Assessment Method and interviewer-rated Confusion Assessment Method. Journal of the American Geriatrics Society.

    Reference category: other comparator or secondary accuracy evidence.

  2. Martins S, Conceição F, Paiva JA, Simões MR, Fernandes L (2014). Delirium recognition by family: European Portuguese validation study of the family confusion assessment method. Journal of the American Geriatrics Society.

    Reference category: independent clinical reference.

  3. Mailhot T, Darling C, Ela J, Malyuta Y, Inouye SK, Saczynski J (2020). Family Identification of Delirium in the Emergency Department in Patients With and Without Dementia: Validity of the Family Confusion Assessment Method (FAM-CAM). Journal of the American Geriatrics Society.

    Reference category: other comparator or secondary accuracy evidence.

  4. Fiest KM, Krewulak KD, Ely EW, Davidson JE, Ismail Z, Sept BG, Stelfox HT (2020). Partnering With Family Members to Detect Delirium in Critically Ill Patients. Critical care medicine.

    Reference category: other comparator or secondary accuracy evidence.

  5. Greindl S, Weiss B, Magnolini R, Lingg C, Mayer H, Schaller SJ (2022). Detection of delirium by family members in the intensive care unit: Translation, Cross-Cultural adaptation and validation of the Family Confusion Assessment Method for the German-Speaking area. Journal of advanced nursing.

    Reference category: other comparator or secondary accuracy evidence.

  6. Xing H, Zhu S, Liu S, Xia M, Tong S, Li L, Li L (2024). An online delirium detection tool: Cross-cultural adaptation of a Chinese version of the Family Confusion Assessment Method. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses.

    Reference category: other comparator or secondary accuracy evidence.

  7. Mailhot T, Bouaouina Z, Khetir I, Gélinas C, Brouillette J, Roussy C, Jarry S, Lavoie P (2025). Translation, Adaptation, and Criterion Validation of the Family Caregiver Assessment Tool for French-Speaking Cardiovascular Patients in Canada (FAM-CAM-Fr). The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres.

    Reference category: other comparator or secondary accuracy evidence.

  8. Mickle AM, Tellor Pennington BR, Abdallah AB, Wang W, Lin N, Oberhaus J, Budelier TP, Park D, Palanca BJ, Wildes TS, Schmitt EM, Inouye SK, Avidan MS (2025). Detection of postoperative delirium by family and caregivers: Evaluation of the family confusion assessment method (FAM-CAM). Journal of clinical anesthesia.

    Reference category: other comparator or secondary accuracy evidence.

Copyright and reuse
Version
Use the current FAM-CAM supplied by the author-led resource page
Rights holder
Hospital Elder Life Program (copyright); Aging Brain Center (permissions administrator)
Licence
ALL-RIGHTS-RESERVED-PERMISSION-REQUIRED
Information checked
2026-07-19

Instrument-specific terms apply. See the access and copyright policy or send a correction.

Base clinical review: 2026-07-29. Instrument description source check: 2026-09-05. Scope and limitations.