Appendix 114-L Assessment Instruments for Non-Medicaid Home and Community Based Services: Bakas Caregiving Outcomes Scale (BCOS) | HCBS-5300-MANUAL

The Bakas Caregiving Outcomes Scale (BCOS) was originally developed in 1994 to measure life changes in family caregivers of stroke survivors. The BCOS has been requested for use with a variety of other caregiving populations. The BCOS is copyrighted; however, the Division of Aging Services has obtained written permission from the developer for its use.

Based on the Caregiver Burden section of the Risk Assessment Tool (Section H) using the Zarit Burden Index or based on professional judgement, staff may complete the BCOS assessment tool.

Before using the BCOS, staff must complete webinar #27 entitled “Assessing Caregiver Burden” on the Rosalynn Carter Institute website.

Administer the BCOS by asking each of the first 16 questions and selecting the degree of change experienced by the caregiver from the dropdown menu after each question.

After question #16, there is a question about any other changes in the person’s life as a result of providing care. If you check the box, question 17 will appear with a text box to write the changes described by the person and to rate that change. Up to three additional changes can be added. These answers can be critical in identifying areas of concern for the caregiver and lead to interventions that can provide maximum support.

The specific questions allow interventions / referrals / activities to be tailored to that specific area of the caregiver’s life with the goal of improving the well-being of the caregiver.

The DAS data system automatically converts the responses to a score and totals each question to get an overall score. Each item #1 - #15 is scored. Items #16 – 19 are not included in the scoring. If all answers are “Changed for the Worst”, the total score = 15. If all answers are “Changed for the Best”, the total score = 105. Only as a marker, if each item is answered “No Change”, the total score = 60.

The BCOS is not intended to score one caregiver against another, but to measure changes in a caregiver’s experience over time. While one could postulate that a caregiver with a low score has had a more difficult time coping with caregiving than someone with a higher score, such interpretations and comparisons among clients and potential clients should be made judiciously.

Gayle Alston of the Rosalynn Carter Institute for Caregiving provided the following visual representation of the domains that relate to each question on the BCOS.