Modified caregiver role strain

Assignment Requirements

Modified Caregiver Strain Index

Directions: Here is a list of things that other caregivers have found to be difficult. Please put a checkmark in the columns that apply to you.

We have included some examples that are common caregiver experiences to help you think about each item. Your situation may be slightly

different, but the item could still apply.

Yes, On a Regular Basis=2 Yes, Sometimes =1 No=0

 

My sleep is disturbed ____________ ____________ ____________

(For example: the person I care for is in and out of bed or

wanders around at night)

 

Caregiving is inconvenient ____________ ____________ ____________

(For example: helping takes so much time or it’s a long

drive over to help)

 

Caregiving is a physical strain ____________ ____________ ____________

(For example: lifting in or out of a chair; effort or concentration

is required)

 

Caregiving is confining ____________ ____________ ____________

(For example: helping restricts free time or I cannot go visiting)

 

There have been family adjustments ____________ ____________ ____________

(For example: helping has disrupted my routine; there is no privacy)

 

There have been changes in personal plans ____________ ____________ ____________

(For example: I had to turn down a job; I could not go on vacation)

 

There have been other demands on my time ____________ ____________ ____________

(For example: other family members need me)

There have been emotional adjustments ____________ ____________ ____________

(For example: severe arguments about caregiving)

Some behavior is upsetting ____________ ____________ ____________

(For example: incontinence; the person cared for has trouble remembering

things; or the person I care for accuses people of taking things)

 

It is upsetting to find the person I care for has changed so

much from his/her former self ____________ ____________ ____________

(For example: he/she is a different person than he/she used to be)

 

 

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