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/