SOCIAL-ADAPTIVE FUNCTIONING EVALUATION (SAFE) - A RATING-SCALE FOR GERIATRIC PSYCHIATRIC-PATIENTS

Geriatric chronic psychiatric inpatients often remain in a chronic psy chiatric hospital because of serious deficits in adaptive life functio ns. Because the additional complications and adaptive changes associat ed with aging have not been considered in previous scales, the Social- Adaptive Functioning Evaluation (SAFE) was developed. The items in the scale measure social-interpersonal, instrumental, and life skills fun ctioning and are designed to be rated by observation, caregiver contac t, and interaction with the subject if possible. Interrater and test-r etest reliability were examined (n = 60) and convergent and discrimina nt validity were rated against other relevant measures (n = 50) in sep arate studies, with all being found adequate. The factor structure of the scale was examined with exploratory factor analysis, revealing a t hree-factor structure. Finally, predictive validity was examined in a preliminary study of 140 patients, 45 of whom were discharged after th e assessment. The results indicate that patients who remained hospital ized could be discriminated from those who were sent to nursing homes or community care on the basis of certain SAFE items and subscales. Th ese results support the use of this instrument in later studies of ger iatric psychiatric patients.