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Care-Giver's Self-Assessment

Caregivers are often so concerned with caring for their relative's needs that they lose sight of their own well-being. 

If you are a caregiver, you can use this self-assessment to find out how well you are coping with the challenges of being a regular or full-time caregiver.

Answer these questions based on your experience during the past
week or so:

1. I have had trouble keeping my mind on what I was doing.........   __Yes  __No

2. I felt that I couldn't leave my relative alone.............................   __Yes   __No

3. I had difficulty making decisions...........................................   __Yes   __No

4. I felt completely overwhelmed...............................................   __Yes   __No

5. I felt useless and unneeded..................................................  __Yes   __No

6. I felt lonely..........................................................................  __Yes   __No

7. I have been upset that my relative has changed so much  ......  __Yes   __No
    from his/her former self
8. I felt a loss of privacy and/or time for myself...........................  __Yes   __No

9. I have been edgy or irritable..................................................  __Yes   __No

10. My sleep was disturbed because I was caring for my relative.  __Yes   __No

11. I had one or more crying spells...........................................  __Yes   __No

12. I felt strain or tension between my work and family      .........  __Yes   __No
     responsibilities
13. I experienced back pain.....................................................  __Yes   __No

14. I felt ill (headaches, stomach problems or common cold)......  __Yes   __No

15. I felt unsatisfied with the support my family has given me.....   __Yes   __No

16. I found my relative's living situation to be inconvenient or .....   __Yes   __No
     a barrier to care

Total the number of "Yes" responses here ..........................................  _____

17. On a scale of 1 (low) to 10 (high), rate your current level of stress:     _____

18. On a scale of 1 (low) to 10 (high), rate your current health compared  _____
     to what it was at this time last year.

How to Interpret Your Score

Chances are that you are experiencing a high degree of distress:
• If you answered "Yes" to either or both questions 4 and 11;
• If your total "Yes" score is 10 or higher;
• If your score on question 17 is 6 or higher;
• If your score on question 18 is 6 or lower.

What to Do Next

If this self-assessment suggests that you are experiencing some distress as a result of your role as a care-giver, you may consider:
• seeing your family doctor for a check-up for yourself;
• making plans with a health care professional or social worker to arrange for some
  relief from your caregiving responsibilities;
• joining a support group for caregivers.
• visiting with your pastor, a pastoral care minister or a spiritual guide.

This self assessment was adapted from the caregiver's self assessment created by the American Medical Association and provided by the PBS series Caring for Your Parents, available online at:
www.pbs.org/wgbh/caringforyourparents/

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Posted 11.09.09   Last Update: 11.09.09

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The Catholic parishes in Waterloo are committed to providing life-long faith formation and spiritual growth for adults of all ages. We value individual life experience, respect the diversity of personal convictions, and welcome the wisdom of every participant. We encourage conversation and dialogue. We will never intentionally embarrass or offend participants.

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