Caregiver Self Assessment Questionnaire

How do I know when it's time to seek help for the care of my loved one in order to maintain my own health?
A study of elderly spouse caregivers, aged 66 to 96: found that caregivers who experience mental or emotional strain have a 63% higher risk of dying than non-caregivers. Caregivers are often so concerned with care for their relative's needs, that they lose sight of their own well being.

Please use the caregiver self-assessment questionnaire below to help assess your need for help.

Please take just a few minutes to answer the following questions. Answer Yes or No

During the past week or so, I have...

1. Had trouble keeping my mind on what I was doing
2. Felt that I couldn't leave my relative alone
3. Had difficulty making decisions
4. Felt completely overwhelmed
5. Felt useless and unneeded
6. Felt lonely
7. Been upset that my relative has changed so much from his/her former self
8. Felt a loss of privacy and /or personal time
9. Been edgy and irritable
10. Had sleep disturbed because of caring for my relative
11. Had a crying spell or spells
12. Felt strained between work and family responsibilities
13. Had back pain
14. Felt ill (headaches, stomach problems or common cold)
15. Been dissatisfied with the support my family has given me
16. Found that my relatives living situation to be inconvenient or a barrier to care
17. On a scale of 1 to 10, with 1 being "not stressed" to 10 being "extremely stressful," please rate your current level of stress
18. On a scale of 1 to 10, with 1 being "very healthy" to 10 being "extremely ill," please rate your current health compared to what it was this time last year.

To determine the score total the number of "yes" responses. Chances are you are experiencing a high degree of distress if your total score is 10 or more; you answered "yes" to questions 4 and 11 or your score on either question 17 or 18 was 6 or higher.

Consider seeing a doctor for a check-up for yourself.

Consider having some relief from care giving. Contact the Silverado Senior Living community nearest you. Short respite care is also available, and every Silverado community offers support groups with free respite care during the program at no charge to you.

Consider joining any support group!