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Caregiving Financial Assessment

    For each item, select the number that best describes your situation. Total your scores to get a big picture. Lower scores indicate less manageable situations; higher scores indicate situations that may be more readily managed.

    The care receiver:

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    _____ (1) Has few if any financial assets

    _____ (2) Doesn't qualify for government assistance programs

    _____ (3) Is financially able to pay for needed support and care

    The caregiver:

    _____ (1) Has no financial assets to give to the patient's care

    _____ (2) Has minimal financial assets that will soon be depleted

    _____ (3) Is able to assume financial support of patient

    For either caregiver or care recipient:

    _____ (1) The financial situation is expected to worsen in the future

    _____ (2) The financial situation is expected to remain stable in the future

    _____ (3) The financial situation is expected to improve in the future

    How permanent is it?

    _____ (1) The decision to provide in-home caregiving cannot be reversed

    _____ (2) The decision to provide in-home caregiving cannot be readily reversed

    _____ (3) The decision to provide in-home caregiving can be readily reversed

    How long?

    _____ (1) In-home caregiving is expected to be a long-term situation

    _____ (2) The duration of in-home caregiving is very much uncertain

    _____ (3) In-home caregiving is expected to be a short-term situation

    Legal Factors

    _____ (1) There are complicating legal factors to consider

    _____ (2) There are a few minor legal considerations

    _____ (3) There are no legal complications to consider

    Relocation

    _____ (1) Required relocation is unwanted on the part of both caregiver and care recipient

    _____ (2) Required relocation is unwanted on the part of one party

    _____ (3) Relocation is not required, or if it is, it isn't a problem

    Size of Home

    _____ (1) Caregiver's home is inadequately sized and equipped to provide the needed care,

    and renovation is not possible or affordable

    _____ (2) Caregiver's home is inadequately sized and equipped, but renovation is possible

    _____ (3) Caregiver's home is adequately sized and equipped to provide the needed care

    Household Privacy

    _____ (1) Privacy for each household member is not possible

    _____ (2) Privacy can be arranged for each household member with minimal effort

    _____ (3) There is adequate time and space for each household member to have some privacy

    Scoring

    Lower scores indicate less manageable situations; higher scores indicate situations that may be more readily managed.

    Lowest possible score: 9

    Highest possible score: 27

    Your score: 

    WebMD Medical Reference

    Reviewed by Laura J. Martin, MD on December 10, 2012
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