Caregiving Financial Assessment
For each item, select the numbered statement that best describes your situation. Total your scores by adding the numbers of the selected statements 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
_____ (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
_____ (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
_____ (1) There are complicating legal factors to consider
_____ (2) There are a few minor legal considerations
_____ (3) There are no legal complications to consider
_____ (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
_____ (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
Lower scores indicate less manageable situations; higher scores indicate situations that may be more readily managed.
Lowest possible score: 9
Highest possible score: 27