Caregivers Support and Assessment

Caregiver Self-Assessment

UnityPoint Health is dedicated to providing caregivers the support they need to take care of themselves as they are caring for someone they love. Please take a moment to complete the two exercises below.

Exercise A

Use the thermometer as a guide by picking a number (0-10) that best describes how much distress you have experienced in the past week, including today.

Exercise B

It is helpful to be aware of your specific stressors.  Please place a check next to the statements below to identify what you have experienced in the past week, including today.

__ Difficulty leaving my loved one alone

__ My own health concerns

__ Ignored my own basic needs

__ Lack of support from family and/or friends

__ Feeling torn between responsibilites

__ Feeling edgy or irritable

__ Feeling down, depressed or hopeless

__ Feeling disconnected

__ Loss of meaning of life

__ Feeling nervous, anxious, on edge

__ Not being able to stop worring

__ Little interest/pleasure in doing things


Click here for a list of resources available as you care for your loved one