Caregiver Burden Inventory

(Novak and Guest, 1989)

The Case Manager will administer the inventory by reading the statement and marking the
responses.
Choose the number that best represents how often the statement describes your feelings.
0 - Never
1 - Rarely
2 - Sometimes
3 - Quite Frequently
4 - Nearly Always

Client Name_______________________ Caregiver Name ______________________Date____________

Time Dependency Items Emotional Health Items
He/she needs Social Development
my help to perform
Relationships Items
Items I feel embarrassed over his/her
many
feel daily
that I tasks
I don't get along with other family
I am missing out on behavior


life
members asdependent
well as I used to I feel ashamed of him/her
He/she
I wish is
careIgiving
could efforts on me
escape aren't
from this

My
situation
I have to watch him/her
I resent him/her
appreciated by others in my family
My social
constantly life haswith
suffered
my marriage
I feel uncomfortable when I have
I've
I
had
have
problems
to help him/her with many
friends over
(or other
I feel significant drained
emotionally relationship)
due to
as well as I used to
basic functions I feel angry about my interactions
I don't
caringget
I don't
foralong
have
him/her
a minute's break be with him/her
with others that things would
I expected
from
I feel his/her
different
resentful
at thischores
ofpoint
otherin my lifewho
relatives
Scores near or above 36 indicates a greater
could but do not help need for respite and other services.

It is important to seriously look at any item on the burden scale where

Total the answer was scored as a
Score:
3 or 4 ('quite frequently' or 'nearly always'). If you have a 3 or 4 as an answer, give careful
thought about why the caregiver scored so high on the question and see if you can find away to
reduce the stress.

Comments:____________________________________________________________________
______________________________________________________________________________
________________________________________
Physical Health Items
________________________________________
I'm not getting enough sleep ________________________________________
My health has suffered ________________________________________
Care giving has made me ________________________________________
physically sick __________________________________
I'm physically tired