Caregiver Burnout Assessment Survey

The Caregiver Burnout Assessment Survey is a structured evaluation tool designed for healthcare systems, geriatric practices, palliative care programs, home health agencies, and social service organizations that support family caregivers and professional care partners. With over 53 million Americans serving as unpaid caregivers and studies showing that 40 to 70 percent of family caregivers exhibit clinically significant symptoms of depression, the need for proactive caregiver burden screening has never been greater. This caregiver stress survey adapts principles from the Zarit Burden Interview, one of the most widely cited and validated instruments for measuring caregiver burden, into a digital format that can be completed before or during a clinical encounter.

The survey is organized into sections that assess the full spectrum of caregiver experience. The caregiving situation section captures who the caregiver is caring for, the care recipient's primary diagnoses, the type and intensity of care provided (personal care, medication management, transportation, financial management, emotional support), hours per week spent caregiving, and duration of the caregiving role. The Zarit Burden style questions evaluate the caregiver's feelings of strain, embarrassment, anger, loss of control, uncertainty, social isolation, financial pressure, and the sense that they should be doing more. A self-care assessment section asks about the caregiver's own physical health, sleep quality, exercise, nutrition, social engagement, and whether they have their own primary care provider and attend their own medical appointments.

This caregiver burden questionnaire concludes with a support needs assessment that identifies which resources would be most helpful to the caregiver, including respite care, support groups, counseling, financial assistance, home health aide services, adult day programs, and educational materials about the care recipient's condition. A consent section allows the caregiver to opt in to receiving referrals and follow-up from social workers, care coordinators, or community resource organizations. The survey is ideal for geriatric care management programs, oncology practices assessing the families of cancer patients, neurology clinics caring for dementia patients, hospice and palliative care teams, pediatric practices supporting parents of children with complex medical needs, and any healthcare organization that recognizes caregiver wellbeing as integral to patient outcomes.