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Caregiver Self-Stress Questionaire

You have taken on the caregiver role for your elderly family member because of your compassion and dedication to making sure your loved one is safe, secure and has the best quality of life possible in their final years.

With so many things to monitor and manage, it's easy to put your own needs aside. Although coming from the best of intentions, the result is an increased risk of caregiver burnout.  If your physical, mental, and emotional health are compromised, you are unable to care for your loved one as much as you would like and as they deserve.

In the safety demonstration before every flight, you are told to put your own oxygen mask on first before attending to others' needs. Obviously, you cannot be of help to anyone if you pass out due to a lack of oxygen!  Consider your role and responsibility of the caregiver in the same way.

You can be so busy tending to all the demands on you as a caregiver that you don't see - or pay enough attention to - the warning signs that you're heading towards burnout.

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To be more mindful and check in with how the stress of caregiving could be affecting you, please complete the brief questionnaire below, and read up on some of the tips and suggestions that can help you better manage the very real stress of caregiving for an elderly loved one.


Assign a score depending on how you answer each question. Add up all points for your total, and review the description for each score range.

Daily = 4 points, Often = 3 points, Sometimes = 2 points, Never = 1 point. 


1. How often do you get a regular night's sleep (7-8 hours)?

2. How often are you eating a healthy, balanced diet?

3. How often are you exercising (including stretching, strength and cardio)?

4. How often are you able to relax without the use of sedatives (ie: alcohol, medication)?

5. How often do you feel happy?

6. How often do you feel someone is caring for YOU?

7. How often do you avoid stimulants (ie: cigarettes, coffee) to get through the day?

8. How often do you take a break to re-group if you are feeling irritable?

9. How often do you take measures to improve your ability to concentrate?

10. How often do you "recharge your batteries" to have the energy to do everyday tasks?

11. How often do you take measures to reduce feeling overwhelmed by everything you have to do?

12. How often does someone compliment or commend you on your caregiving efforts?

Total the points you gave yourself and read your results below.


What Your Score Means

42 - 48  Low burnout risk.
You're taking a balanced approach to your caregiver role.  Your head and heart are in the right space.  You have a good range of resources you can access, and you make time to care for yourself, and do the things which you enjoy.  Well done!  Remember, the stress of caregiving can sneak up unawares, so it's important to regularly check in with yourself.


Tip:  Make sure you are making time for YOU every day.  Take a few minutes to sit quietly and just be aware of your breath and release any tension your body might be holding onto.  Mindfulness is key.

30 - 41 Moderate burnout risk. 
You may feel you are handling the caregiver stress reasonably well, but are starting to fall into the trap of putting yourself to the bottom of your priorities list.  Not tending to your own needs leads to chronic stress and a compromised immune system which increases your risk for a range of health challenges including depression.

Tip:  Find ways to protect your "me" time.  Stay connected with friends and pursue activities you enjoy. Make the time to pamper yourself.  It's not an indulgence to find ways to help reduce your stress and raise your spirits.

18- 29 High risk for burnout.
You are seriously stressed out, and may already be dealing with some of the common symptoms like anxiety and depression.  If you've been caregiving for some time, you're physically worn out, which can cause or further complicate health issues like heart disease, hypertension or diabetes.  It's critical you get immediate support to help you lower your stress by learning better self-care management, getting others to help with the workload, and finding ways to express the emotional roller coaster you're on through counseling or within a caregiver support group.

Tip:  Aside from the suggestions in the previous category, it's vital you truly understand the causes of your caregiver stress.  They may not be as obvious as you believe. Click here to learn ways to address and manage them.  Also give serious consideration to finding respite care for you as you are in serious need of a break!

12 - 17 Already experiencing burnout. 
You, my friend are running on empty and at serious risk of your own physical, mental or emotional health being compromised. You know you are unable to continue in the caregiver role if you don't do something NOW. 


Tip: Seek immediate help from someone you trust.  Talk to your doctor, a therapist or your clergy person for guidance in their respective areas of expertise.  You may need to seriously consider a break from caregiving and take an overdue vacation.  You may also need to consider the time has come to have your loved one placed into a facility if their health issues are now needing full, 24-hour complex care. You can't do that, nor should you try.

What's Next for You as a Caregiver?

This questionnaire gives an overview of what you might be dealing with.  The role of caregiving is, of course, much more complex and involved than can be addressed here. 


Without the proper physical, mental and emotional support you need, your risk of burnout will cause both you and your elderly loved on to suffer. It's critical that you take steps to make sure your needs are addressed.  Below is a list of the common signs and symptoms of caregiver stress and burnout for you to be aware of:


Caregiver Stress: anxiety, depression, irritability, trouble getting/staying asleep. new or worsening health challenges,

difficulty concentrating, feelings of resentment, drinking/smoking/eating more, neglecting responsibilities, less time spent on once enjoyable activities.


Caregiver Burnout: getting sick more easily, constant exhaustion, neglect own needs, trouble relaxing, increased impatience with care receiver, feeling helpless and hopeless.


For a closer look at how you could create more support through your caregiver journey.
Please click here to request a Discovery call and learn how I may be able to work with you.

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