Try Our Caregiver Stress Test to See How You are Coping

 

Caregivers Name :
Are you the:  Spouse Sibling Child
Age of Relative:
Aging Relatives Name:
Contact Number:
1. I currently spend the following number of hours per WEEK caring for an aging parent/relative:
 1-10 hours
 11-20 hours
 21-30 hours
 31+ hours
2. I travel the following distance to care for my aging parent/relative:
 My relative lives with me
 Less than 30 minutes
 31 minutes - 2 hours
 More than 2 hours
3.What city does your aging parent live in?
4. The amount of care my aging parent/relative requires is very demanding:
 Strongly Agree
 Agree
 Disagree
 Strongly Disagree