SMART NMO - Caregiver Version
Systematic Mental Health Assessment and Response Tool for NMOSD
Esiason, Genecov, Nurse, Peppers, Levy & O’Hayer, 2022, revised 2025
Note: No data is saved for the user or for the host on this page. If you would like to keep these answers and scores for your records, please write them down or print out this page.
Please respond to the best of your ability, based on your perceptions of your loved one with NMOSD.
Do you live with your loved one with NMOSD?
-- Select one --
Yes
No
What is their aquaporin-4 (AQP4) serostatus?
-- Select one --
Positive
Negative
Unknown
In the past 4 weeks, have you observed that your loved one with NMOSD was:
Isolated, alone & emotionally lonely?
-- Select one --
Much of the time
Some of the time
None of the time or Unknown
Anxious about medical appointments?
-- Select one --
Much of the time
Some of the time
None of the time or Unknown
Anxious about others' concern/worry about them??
-- Select one --
Much of the time
Some of the time
None of the time or Unknown
Anxious about treatment days (anticipatory anxiety beforehand AND anxiety while at the clinic)?
-- Select one --
Much of the time
Some of the time
None of the time or Unknown
Overwhelmed (by loud noise or chaos, by work or personal responsibilities, by maintaining relationships, etc.)
-- Select one --
Much of the time
Some of the time
None of the time or Unknown
How true are the following statements over the past 4 weeks?
Your loved one is concerned with how others understand their disease (friends and family minimizing “invisible illness,” strangers staring at the way they walk, etc.)
-- Select one --
Very true
Somewhat true
Neutral, false, or unkwown
NMOSD limits your loved one’s ability to make short-term plans for the future.
-- Select one --
Very true
Somewhat true
Neutral, false, or unknown
NMOSD limits your loved one’s ability to make long-term plans for the future.
-- Select one --
Very true
Somewhat true
Neutral, false, or unknown
Your loved one with NMOSD exhibits concern about their physical appearance.
-- Select one --
Very true
Somewhat true
Neutral, false, or unknown
Your loved one with NMOSD is worried about the possibility of a relapse of their symptoms.
-- Select one --
Very true
Somewhat true
Neutral, false, or unknown
You do NOT trust your loved one’s medical team to care for their NMOSD
-- Select one --
Very true
Somewhat true
Neutral, false, or unknown
How has NMOSD affected your loved one's personality or identity?
-- Select one --
Positively or not at all
Somewhat negatively
Very negatively
In general, would you say your loved one with NMOSD's health is:
-- Select one --
Great to good
Fair
Poor
Compared to one year ago, how would you rate your loved one's health in general now?
-- Select one --
Better or the same
A bit worse
Much worse
Get my score
If your total score is 5 or higher, your loved one will likely benefit from a referral to a mental health treatment to help them cope with NMOSD.