Caregiver Self-Assessment Questionnaire - National Caregivers ...

Self-evaluation:To Determine the Score:1.Reverse score questions5 and 15. (For example,a “No” response should becounted as “Yes” and a“Yes” response should becounted as “No”)2.Total the numberof “yes” responses.To Interpret the Score:Chances are that youare experiencing a highdegree of distress:• If you answered “Yes” toeither or both Questions4 and 11; or• If your total “Yes” score= 10 or more; or• If your score onQuestion 17 is 6 orhigher; or• If your score onQuestion 18 is 6 orhigher.Next steps:• Consider seeing adoctor for a check-upfor yourself.• Consider having somerelief from caregiving.(Discuss with thedoctor or a social workerthe resources available inyourcommunity.)• Consider joining asupport groupValuable Resourcesfor Caregivers:Eldercare Locator:(a national directory ofcommunity services)1-800- 677-1116www.aoa.gov/elderpage/locator.htmlFamily Caregiver Alliance1-415- 434-3388www.caregiver.orgMedicaid HotlineBaltimore, MD1-800-638-6833National Alliance forCaregiving1-301-718-8444www.caregiving.orgNational FamilyCaregivers Association1-800 896-3650www.nfcacares.orgNational InformationCenter for Children andYouth with Disabilities1-800-695-0285www.nichcy.orgLocal Resources and Contacts:For additional tools for caregiving or aging, visit www.CaregiversLibrary.org