II. Indications

  1. Assess burden in relatives of impaired elderly

III. Questions (rated as 0-Never to 4-Nearly always)

  1. Self-administered survey completed by caregiver
  2. General feelings
    1. Not enough time for self
    2. Over-taxed with responsibilities
    3. Lost control of life
  3. Feelings regarding caring for relative
    1. Uncertain about what to do for relative
    2. Feeling that should do more for relative
    3. Feeling that could do a better job of caring
    4. Overall level of burden
  4. Sense of responsibility
    1. Excessive help requests
    2. Level that impaired relative depends on caregiver
    3. Sense that all responsibility falls on one caregiver
    4. Fear of future regarding impaired relative
    5. Fear of not enough money to care for relative
    6. Fear of not able to continue caring for relative
    7. Wish to leave care of relative to someone else
  5. Feelings when with impaired relative
    1. Sense of strain
    2. Anger
    3. Embarrassed
    4. Uncomfortable about having friends over
  6. Relationship with relative negatively impacts
    1. Social life
    2. Other relationships with family and friends
    3. Caregiver health
    4. Privacy

IV. Interpretation

  1. No or minimal burden: 0 to 20
  2. Mild to moderate burden: 21 to 40
  3. Moderate to severe burden: 41 to 60
  4. Severe burden: 61 to 88

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