Please answer the following questions as a helper or caregiver with yes or no
1. Do you sometimes have trouble making (___) control his/her temper or aggression?
2. Do you often feel you are being forced to act out of character or do things you feel bad about?
3. Do you find it difficult to manage (___’s) behavior?
4. Do you sometimes feel that you are forced to be rough with (___)?
5. Do you sometimes feel you can’t do what is really necessary or what should be done for (___)?
6. Do you often feel you have to reject or ignore (___)?
7. Do you often feel so tired and exhausted that you cannot meet (___‘s) needs?
8. Do you often feel you have to yell at (___)?
A response of “no” to items 6‚ 8‚ 13‚ and 15 and a response of “yes” to all other score in the abused direction.
This instrument can be found at: http://www.ahrq.gov/downloads/pub/prevent/pdfser/famviolser.pdf
Reis M‚ Nahmiash D. (1995).Validation of the Caregiver Abuse Screen (CASE). Canadian Journal on Aging. 1995;14(2):45-60.
Nelson. Heidi‚ Nygren. Peggy‚ McInerney. Yasmin‚. (2004). Screening for Family and Intimate Partner Violence. U.S. Department of Health and Human Services Agency for Healthcare Research and Quality. Systematic Evidence Review; 28. www.ahrq.gov