Caregiver Questionnaire

The world of Caregiving is an intricate and challenging one at any time and under any circumstances. However, our current fast-paced world with its increasing technology, changing approaches to healthcare and shifting of social values is adding increased complexity to the role of personal and professional caregivers.

There is a great need to address the needs of this group in order to:

  1. prevent burn out and compassion fatigue,
  2. assure that those in need of care receive the level of care they require and deserve, and
  3. promote a nourishing inner and outer environment for both the giver and receiver.

Through meeting these objectives the experience of caregiving can be a life enhancing one for all concerned rather than a nightmare of stress and broken spirits.

Currently, we are gathering stories about caregiving and the various aspects involved in the role of caregiver. Would you share your story with us? We are writing a book that will include helpful strategies and solutions to the many stresses that are unique to caregivers. Your input will help us provide a realistic picture of the caregiver's landscape and a comprehensive approach to addressing the issues at the heart of caregiving. As a "thank you" you will receive a complimentary copy of our book when it is done.

1. How did you end up in the caregiver role?







3. What type of care giving role are you in?








4. How long have you been (or were you) in a care giving role?






5. How much time do you spend in the role of caregiver?









May we have your permission to use all or part of your story in our printed materials? Each and every story is so helpful to other people in similar positions. We would like permission to use the parts that will be most relevant to others. You can provide permission and also remain anonymous, if you wish.