Caregivers Count Too! Section 3: When Should a Family Caregiver Assessment Happen?

When Should Assessment Happen?

As early as possible:

• Many experts recommend a screening first (see Definitions in Section 1).

  Mr. Rodriguez

  Mr. Rodriguez has been caring for his wife Miranda, who has Alzheimer’s disease, for more than four years. In addition to managing her finances and preparing all of her meals, he also accompanies her to all of her doctor appointments. At a recent visit to Miranda’s primary care physician’s office, the receptionist handed him a brief caregiver screening questionnaire. It had five yes or no questions:*

  1. Do you help someone 60 years of age or older who is not in good health or is not managing as well as he or she used to?
  2. Is it ever hard to help this person in any way?
  3. Do you ever worry about the health or well-being of this person?
  4. Do you ever feel at all stressed when you are helping this person?
  5. Would you like more information about services and supports for caregivers?

  Because he responded “yes” to the last question, Mr. Rodriguez was referred to his local Area Agency on Aging. There the caregiver support program specialist asked if he would like to have a complete assessment of his situation. He said yes, so she conducted a full assessment with him. The caregiver specialist was able to respond to Mr. Rodriguez’s needs by offering him customized services including a caregiver support group and dementia training.

  * Adapted from: The University of Maine (2005). Maine Primary Partners in Caring Project’s Brief Patient Screen

• Lots of events can trigger a caregiver assessment. These include:
  • Professional referrals such as those from pharmacists, physicians, clergy, parish nurses, home care workers, Adult Protective Service and the courts
  • Self-referral by the family member
  • Diagnosis of a medical condition
  • Decreased functional status of caregiver or care recipient (e.g., no longer safe to leave care recipient alone)
  • New patient, health plan enrollee or Medicare beneficiary
  • Complaint from a care recipient
  • Care transitions (e.g., from home to assisted living or to nursing home, or from hospital to home)
  • Caregiver workplace issues (e.g., performance or attendance problems)
  • Concern from another family member or friend

Assessment should be an ongoing process:

• Reassessment should occur periodically (e.g., every three to six months). The key question: “Has anything changed?” or “How are things going?”
• Reassessment may involve a shorter version of the original assessment instrument, reducing the time demands on caregivers and the service agency.
• Reassessment is needed because:
  • Things change. The care recipient’s or caregiver’s health and functioning may call for a new treatment approach or a shift in the mix of services being offered.
  • We need to know how well the care plan is working. Reassessment is an opportunity to evaluate whether goals have been reached, and if there are any unmet needs.

Things to Keep in Mind:

• Many family caregivers may be focused on the needs of the care recipient and may not think about their own situation and concerns. Therefore, family caregivers may be more open to a conversation and assessment of their own needs once an immediate crisis has passed or some support has been put into place.

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