Assessment Tools

AssessmentBeyond the use of open ended clinical interviews, the Task Force recommends psychologists be familiar with structured interviews and questionnaires related to caregiving for use in some clinical situations. Clinicians will need to tailor their use of assessment instruments depending on the characteristics of the caregiver (e.g. age, cultural background), and the care recipient (e.g. age and specific medical problem or disability). We have provided examples of a number of caregiver intake forms; measures of caregiver mental health; and measures of caregiver stress, burden, coping, and family context. We have also provided care receiver measures of behavior and functioning; cognitive problems; quality of care; health problems; and mental health. Finally we have provided instruments that may be particularly useful with caregivers from diverse cultural backgrounds.
Intake Interviews

The Caregiver Intake Interview may be different from assessments psychologists typically undertake to identify individual psychopathology or distress. In order to create strong interventions for a caregiving family, psychologists must gather key information about a range of topics to help determine:

  • The nature of the care-recipient’s illness or disability
  • The family’s stage of caregiving (early, middle or late)
  • The constellation of individuals involved in care, including community support persons, and treating professionals
  • Unique or challenging caregiving circumstances

Seven Domains to Assess

Recommended by the Family Caregiver Alliance’s (FCA) National Center on Caregiving.

  • Background on the caregiver and the caregiving situation.
  • Caregiver’s perception of the health and functional status of the care-recipient.
  • Caregiver’s values and preferences.
  • Health and well-being of caregiver.
  • Consequences of caregiving on the caregiver.
  • Care provision requirements.
  • Resources to support the caregiver.

Assessment Intake Guide Examples

Caregiver Assessment

The questionnaires and interviews found on the following pagesare commonly used with adult caregivers of any background and have been utilized in caregiving research studies and clinical work as well.

Care Receiver Assessment

Sometimes as part of the assessment of the caregiver it is necessary to assess the extent of the problems being experienced by the care receiver.  The tools on the following pages help make that possible.

Assessing Diverse Cultures

Culture is known to influence caregiving. Specifically, issues of acculturation, assimilation, cultural values, beliefs and norms can be important for caregivers. We have included assessment tools that were designed to assess the unique aspects of caregiving among diverse groups. . Although there are few well-known caregiving assessment tools designed specifically for use with diverse populations, several of the better-known tools have been tested across various groups, and have proved to be culturally sensitive instruments.  In particular, the Zarit Burden Index (ZBI; Zarit et al., 1986) has been shown to have a factorial structure that is invariant across Black and White caregiver samples (Flynn Longmire & Knight, 2011).  The ZBI has also been adapted and validated for use with several different languages (Honea et al., 2008).  A modified version of the Caregiver Strain Index (CSI; Sullivan, 2002) has also been shown to have adequate reliability and validity among racial/ethnic minorities (Thornton & Travis, 2003).  Several good reviews of issues of cultural diversity in caregiving research have addressed these specifically in the context of assessment tools, including Dilworth-Anderson, Williams, & Gibson (2002) and Vitaliano, Young, & Russo (1991).

References

Dilworth-Anderson, P., Williams, I. C., & Gibson, B. E. (2002). Issues of race, ethnicity, and culture in caregiving research a 20-year review (1980–2000). The Gerontologist, 42(2), 237-272.

Lynn Longmire, C. V., & Knight, B. G. (2011). Confirmatory Factor Analysis of a Brief Version of the Zarit Burden Interview in Black and White Dementia Caregivers. Gerontologist, 51(4), 453-462.

Honea, N. J., Brintnall, R., Given, B., Sherwood, P., Colao, D. B., Somers, S. C., & Northouse, L. L. (2008). Putting Evidence Into Practice®: Nursing Assessment and Interventions to Reduce Family Caregiver Strain and Burden. Clinical Journal Of Oncology Nursing, 12(3), 507-516. doi:10.1188/08.CJON.507-516

Sullivan, T. M. (2002). Caregiver Strain Index (CSI). Retrieved from the Hartford Institute of Geriatric Nursing website at http://www.geronurseonline.org/uploaded_documents/CaregiverStrainIndex.pdf

Thornton, M., & Travis, S. S. (2003). Analysis of the Reliability of the Modified Caregiver Strain Index. Journals Of Gerontology Series B: Psychological Sciences & Social Sciences, 58B(2), S127.

Vitaliano, P. P., Young, H. M., & Russo, J. (1991). Burden: A review of measures used among caregivers of individuals with dementia. The Gerontologist, 31(1), 67-75.

Zarit, S., Todd, P. A., & Zarit, J. M. (1986). Subjective burden of husbands and wives as caregivers: A longitudinal study. Gerontologist, 26, 260–266.