CARES Observational Tool


The CARES® Observational Tool (or COT) is an easy-to-administer observational tool for assessing staff behavior. It was designed around person-centered care concepts taught in the CARES® Dementia Basics & Advanced Care Online Training Program.

Recommended uses include:

  • Staff training to teach key concepts of person-centered care
  • Staff observations to evaluate level of person-centered care
  • Peer observations for “hands-on” practice sessions
  • Documentation for staff files
  • Documentation for family meetings
  • Documentation for inspectors and surveyors


  • Easy to use
  • Easy to score
  • Full set of definitions/examples on pages 2-3 for your reference
  • Great for staff training, evaluation, and documentation

The 16 COT observation areas/key points in person-centered care include:

  1. Greet the Person
  2. Introduce Yourself
  3. Use Their Name
  4. Smile/Make Eye Contact
  5. Physical Contact
  6. Your Approach
  7. Your Eye Level
  8. Calm Approach
  9. Ask/Discuss/Assess
  10. 15 Seconds
  11. Explain Care
  12. Involve Person in Care/Activity
  13. Mention Resident’s Life
  14. Provide Comfort
  15. Share with Others
  16. Write and Document

Scoring and Definitions

The COT’s streamlined “1” or “0” scoring makes it easy to administer for any level of supervisory staff. In fact, it is even appropriate for peer-administered observations and can be used by any staff member, regardless of age or experience level.

When you purchase a COT license, you will also receive a full set of “definitions” and examples of what qualifies as an acceptable observable behavior. For example, if the staff member says, “Do you need to go to the bathroom,” it would be scored as a “1” in category 9. Ask/Discuss/Assess.

Technical Research Summary of the COT

The COT was developed as part of a grant from the National Institute on Aging.

After the development of an initial version of the tool, face validity was established through multiple revisions of the COT by a study investigator and clinically-trained research assistant. Afterwards, content validity of the COT was established by piloting the tool on 12 observations across 4 nursing homes and additional review by a panel of scientific experts across the country. The final 16-item version of the COT was then tested for inter-rater reliability by 5 reviewers across 5 videos of actual caregivers and nursing home residents depicting various dementia care scenarios. An intra-class coefficient (ICC) of all possible Kappa coefficients resulted in an ICC of .77, which is considered substantial agreement. These results, based on the development, establishment of face and content validity, and inter-rater reliability of the brief and easy-to-use COT emphasize its potential to assess important care interactions between caregivers and residents with dementia.


The research findings were published in the Journal of Geriatric Nursing in 2013. 

Gaugler, J. E., Hobday, J. V., & Savik, K. (2013). The CARES® Observational Tool: A valid and reliable instrument to assess person-centered dementia care. Journal of Geriatric Nursing, 34(3), 194-98. doi: 10.1016/j.gerinurse.2013.01.002

Pricing and Copyright

The COT is a copyrighted, proprietary tool owned by HealthCare Interactive®. It may only be legally used by purchasing one of the licenses below. When you purchase a license, you are authorized to print and use the tool as many times as the license allows, but no more.


If you have any questions about the COT, pricing plans, or implementation, please contact us.