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Posted: May 05, 2005

Spousal Caregiving

A Spousal Caregiver's Self-Assessment on Stress

Bill Andrew

How are you doing as a spousal caregiver?

When is the last time that you asked yourself that question? Or for that matter, when is the last time your physician asked you that question?

How well are you managing the stress in your life as a spousal caregiver? Often, we caregivers are so preoccupied with taking care of our spouse’s needs that we lose sight of our own wellbeing. What are you doing about this potentially deadly situation? If you don’t take care of yourself, who is going to take care of your spouse?

Various studies have linked stress to both heart disease and stroke. Stress may also be a causative factor in cancer and chronic respiratory diseases, and it has been implicated in many other illnesses as well. Depression and anxiety, which affect millions of Americans, can be caused by, or exacerbated by, stress. It has been indicated in flare-ups of asthma, rheumatoid arthritis, and gastrointestinal problems such as irritable bowel syndrome. Think about this -- illness is just the “tip of the stress iceberg.”

Stress also affects you as a spousal caregiver emotionally as well, marring the joy you could otherwise gain from life and loved ones. But, how do you manage this “stress syndrome” in your role as a spousal caregiver?

Sometimes it helps to step back and evaluate your personal situation. The American Medical Association has developed a “Caregiver Self-Assessment Questionnaire” that I have personally found helpful. I have also used this tool in my Alzheimer’s support group with some revealing results. Please take a few minutes to honestly answer the following questions. Once you have answered each question, go down to the “self-evaluation” section and determine your score -- and what that score means for you and what you should do about it.

Caregiver Self-Assessment Questionnaire

During the past week or so, have I…

1. Had trouble keeping my mind on what I was doing? Yes No
2. Felt that I couldn’t leave my spouse alone? Yes No
3. Had difficulty making decisions? Yes No
4. Felt completely overwhelmed? Yes No
5. Felt useful and needed? Yes No
6. Felt lonely? Yes No
7. Been upset that my spouse has changed so much from his/her former self? Yes No
8. Felt a loss of privacy and/or personal time? Yes No
9. Been edgy or irritable? Yes No
10. Had sleep disturbed because of caring for my spouse? Yes No
11. Had a crying spell(s)? Yes No
12. Felt strained between work and family responsibilities? Yes No
13. Had back pain? Yes No
14. Felt ill (headaches, stomach problems, common cold, etc.)? Yes No
15. Been satisfied with the support my family has given me? Yes No
16. Found my spouse’s living situation to be inconvenient or a barrier to care? Yes No
17. On a scale of “1” to “10”, with “1” being “not stressful” to “10” being “extremely stressful”, please rate your current level of stress: ________
On a scale of “1” to “10”, with “1” being “very healthy” to “10” being “very ill”, please rate your current health compared to what it was this time last year: ________
Comments (Please feel free to comment or provide feedback):

Caregiver Self-Assessment Evaluation Results

To determine your score:

  1. Reverse-score the questions #5 and #15. (That is, a “No” response should be counted as a “Yes and a “Yes” response should be counted as a “No.”
  2. Total the number of “Yes” responses.

To interpret the score:

  1. If you answered “Yes” to either or both questions #4 and #11; or
  2. If your total ”Yes” score equals “10” or more; or
  3. If your score on question #17 is “6” or higher; or
  4. If your score on question #18 is “6” or higher, you are probably experiencing a high degree of stress.

Things you should consider doing if indicated by the above results:

  1. Make an appointment with your physician for a check-up.
  2. Obtain some relief from your caregiving activities through respite care. Ask your physician or social worker about available resources.
  3. Join a support group (as we have discussed in prior columns).

Potential caregiver resources for you to consider:

  1. Eldercare Locator (a national directory of community services), 1-800-677-1116.
  2. Family Caregiver Alliance, 1-415-434-3388.
  3. Medicaid Hotline, Baltimore, Maryland, 1-800-638-6833.
  4. National Alliance for Caregiving, 1-301-718-8444.
  5. National Family Caregivers Association, 1-800-896-3650.

Hopefully, this test and results will help you to determine the degree of stress your spousal caregiving activities are generating for you. In medical terms, these activities are called stressors, or events and circumstances that cause stress. Stress itself can be defined as an automatic physical response to any stimulus that requires you to adjust to change. Each perceived threat to your body triggers a cascade of stress hormones that produce well-orchestrated physiological changes -- your heart pounds, your muscles tense, your breathing quickens, beads of sweat appear, you become agitated and frustrated, you become confused and disoriented.

We will address “stress management” -- or as some call it, “stress control” -- in future columns.

If you would like to share your story about how you have dealt with spousal caregiving stress, drop me a line at


“He who is a friend is always a friend,
and a brother is born for the time of stress.”
(Proverbs 17:17)

Bill Andrew identifies himself as a former “nutritionally-empowered Alzheimer’s caregiver” who attributes the slow-down in progression of Alzheimer’s disease in his wife, Carol – and the growth of his own personal emotional, mental, physical, and spiritual capability and strength to provide quality 24/7 care for her in their own home – to the targeted nutritional supplements they both took on a daily basis. Carol went to her Heavenly reward on June 9, 2008 – Bill continues on to advocate for family caregivers. Contact Bill with your caregiving questions and comments via email at

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© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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