Examples of Caregiver Assessment Tools

Caregivers Count Too!
An Online Toolkit to Help Practitioners Assess the Needs of Family Caregivers

Main Page
Introduction
Section 1 - Getting Started
	What is the Caregivers Count Too! Toolkit?
	Who Should Use This Toolkit?
	How is the Toolkit Organized?
	Definitions
Section 2 - Vital & Vulnerable: Family Caregivers
	Who Are Family Caregivers?
	Why Are Family Caregivers Vital to Health Care and Long-Term Care Today?
	Why Should We Assess the Needs of Family Caregivers?
	Online Resources for More Information
	Data Sources for Statistics
Section 3 - The Nuts & Bolts of Caregiver Assessment
	Getting Started
	What Should a Family Caregiver Assessment Include?
	Who Should Be Assessed?
	Who Should Conduct a Family Caregiver Assessment?
	When Should a Family Caregiver Assessment Happen?
	Where Should a Family Caregiver Assessment Take Place?
	Fundamental Principles of Caregiver Assessment
Section 4 - Wrapping Up
	Next Steps
	Examples of Caregiver Assessment Tools
	FCA Resources on Caregiver Assessment
	Selected Annotated Bibliography for Caregiver Assessment
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Examples of Caregiver Assessment Tools

The publications below are available as a downloadable PDF document. To view and print this file you will need Adobe Acrobat Reader. It is available as a free download by clicking here.

California

California uses a distinct assessment tool within a state-funded caregiver support program (the statewide system of 11 California Resource Centers) to examine the needs/situations of family caregivers to aid in care planning and service development. Click here to download the full assessment tool.

Massachusetts

Massachusetts is examining a uniform assessment process for Medicaid Home and Community-Based Services (HCBS) by piloting the use of a new caregiver assessment component. The assessment tool has not yet been tested for reliability or validity. This component identifies the primary family caregiver as a distinct consumer in the HCBS system, integrating family caregiver support into a broader systems framework. Click here to download the full assessment tool.

Minnesota

Minnesota includes a caregiver assessment as part of the state’s uniform assessment process to access publicly funded long-term care services. Click here to download the Minnesota Long Term Care Consultation Services Assessment Form.

Pennsylvania

Pennsylvania uses a uniform assessment process with a caregiver component for all publicly funded programs for older people and their families. Click here to download the Comprehensive Options Assessment Form.

Washington

Washington includes a caregiver component as part of the state’s uniform assessment tool for all HCBS programs for older people and adults with disabilities. Currently state officials are working toward enhancing the tool to include a comprehensive family caregiver assessment. Click here to download the full assessment tool.

Other – American Medical Association (AMA)

The AMA has developed and tested an 18-item Caregiver Self-Assessment Questionnaire to encourage physicians and health practitioners to recognize and support family caregivers. Click here to download the full assessment tool.

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