Support Systems
Things to Consider
Select the number (on a scale of 1-3) that best describes your situation for each item or issue. You can total your scores if you wish to get a big picture of the situation. Lower scores indicate less manageable situations -- situations requiring additional support beyond the primary caregiver -- and higher scores indicate situations that may be more readily managed.
For the care recipient and caregiver:
_____ (1) There are no community support services available
_____ (2) There are some community support services available such as transportation, meals
_____ (3) There is support ready and available to help with long-term care
For the care recipient and caregiver:
_____ (1) There are no informal support groups available
_____ (2) There are inadequate informal support groups
_____ (3) There are networks of informal support available through neighbors, family and
friends, or religious groups
The primary caregiver:
_____ (1) Does not "believe in" accepting help of any kind from anyone
_____ (2) Does not "believe in" accepting help from anyone outside the family
_____ (3) Is open to accepting help from others
The primary caregiver:
_____ (1) Is essentially cut off from participating in social or recreational activities
_____ (2) Is significantly restricted in participating in social or recreational activities
_____ (3) Is able to continue to participate in at least one important social or
recreational activity
The primary caregiver:
_____ (1) Will be isolated from previous activities / relationships with significant others
_____ (2) Relationships outside the home will be significantly restricted
_____ (3) Relationships with significant others can continue on a regular, if somewhat reduced,
basis
The primary caregiver:
_____ (1) Will be essentially cut off from participation in valued religious activities
_____ (2) Will be significantly restricted from participation in valued religious activities
_____ (3) Will be able to maintain participation in valued religious activities
Scoring
Lower scores indicate less manageable situations -- situations requiring additional support beyond the primary caregiver -- and higher scores indicate situations that may be more readily managed.
Lowest possible rating score for this section: 6 **
** indicates a need for significant caregiver support
Highest possible rating score for this section: 18
Your total rating score for this section:
Reviewed by Celia E. Dominguez M.D. WebMD, January 2008.
SOURCES: Anita Davis, RN, M.Ed., director of Health Strategies, Nashville, TN. The National Alliance for Caregiving, Bethesda, MD. Family Caregiver Alliance, San Francisco, CA. National Family Caregivers Association, Kensington, MD.
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