Caregiver Self Assessment Form
Family members are often so concerned with caring for their relative’s needs that they lose sight of their own well-being. Please take just a moment to answer the following questions. Once you have answered the questions, you will be sent the results of the self-evaluation.  In the past week......
I have had trouble keeping my mind on what I was doing *
Felt that I couldn't leave my relative alone *
Had difficulty making decisions about my eldercare situation *
Felt completely overwhelmed *