Caregiver Questionnaire

The material for “What to Do about Mama?” was gathered from caregivers who responded to the following questionnaire. Reading the questionnaire will get you thinking. Reading “What to Do about Mama?” will help you formulate a plan of action.

Caregiver Questionnaire:

Wouldn’t it have been great to have a “manual” that would have given you an idea of what to expect in your role as family caregiver?

We are interested in writing a book about caregiving based on our own experiences as well as yours. The purpose of the book is to help others by sharing caregiving experiences. Additionally, this is an opportunity for you to express feelings you may have been silently harboring.

Thank you for your willingness to answer the following questions. Please use anecdotal examples to clarify your responses when possible.

If there are questions that don’t relate to your experience, feel free to leave them out. You may answer anonymously; no one will be identified in the book. Thank you for your contributions and your cooperation.

1. For whom do/did you provide care? What is/was your relationship?
2. How did you become involved in your role as caregiver?
3. Which other family members are/were involved in this caregiving relationship? What are/were their roles?
4. Were these roles discussed and planned ahead of time, or did they just evolve?
5. How well do/did other involved parties fulfill their responsibilities and your expectations?
6. Describe your role as caregiver and how it changed/has changed over time.
7. What actions did you take in order to meet changing/increasing needs?
8. Identify unforeseen areas of difficulty and how you handle/handled them. Did you enlist outside help from agencies, paid helpers, volunteers or
others?
9. How would you describe your overall caregiving experience? What are/were the positives and negatives?
10. How has caregiving affected your physical and emotional health? What have you done/did you do to cope with the stresses of caregiving?
11. Did you join a support group or receive counseling? If so, please describe how well support groups/counseling fulfilled your needs and
expectations. What do you see as the difficulties and the benefits of support group participation or counseling?
12. How have family relationships changed with all who were involved?
13. How did you feel about caregiving initially, and how did your emotional reactions change before, during and after your caregiving experience?
14. How do you feel the emotions of the other concerned persons affect/affected their actions?
15. Looking back, would you assume your caregiving role again? What would you do differently?
16. If your role as caregiver has ended, have there been residual difficulties or challenges that resulted from your caregiving responsibility?
17. How were finances handled? Were you compensated for your role as caregiver? Did financial issues create hardship or conflict for you and other
family members?
18. Have there been difficulties regarding the logistics of allocating belongings and settling an estate?
19. What recommendations would you give to others who find themselves in caregiving situations?
20. Please address any issues or concerns that weren’t covered by the above questions.

Barbara Matthews

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