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The Montgomery Borgatta Caregiver Burden Scale

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<strong>The</strong><br />

<strong>Montgomery</strong><br />

<strong>Borgatta</strong><br />

<strong>Caregiver</strong> <strong>Burden</strong><br />

<strong>Scale</strong>


CAREGIVING. . . . .<br />

"<strong>The</strong>re are only four kinds of people<br />

in the world - those who have been<br />

caregivers,<br />

those who currently are caregivers,<br />

those who will be caregivers,<br />

and those who will need caregivers."<br />

Former First Lady Rosalyn Carter


Burnout . . the complete<br />

drain of our physical,<br />

spiritual, and emotional<br />

reserves, occurs when a<br />

caregiver slips beyond<br />

exhaustion or depression.<br />

Source: <strong>The</strong> Comfort of Home, Maria M. Meyer with<br />

Paula Derr, RN.


Family caregivers are more<br />

frequently depressed (30%-90%),<br />

anxious and more likely to use<br />

psychotropic medications than the<br />

rest of the population. General<br />

practitioners, however, fail to<br />

diagnose 30% - 50% of depression<br />

cases, and even when they do<br />

properly diagnose depression, they<br />

often under treat it.<br />

Source: Zarit, S., Zarit, J., and Zarit A.<br />

Mental Disorders in Older Adults: Fundamentals of<br />

Assessment and Treatment,@ New York: <strong>The</strong> Guilford Press<br />

(1989). Goff, V.A. Depression: A Decade of Progress, More<br />

to Do@ (Issue Brief No. 786) National Health Policy Forum,<br />

George Washington University, Washington, DC (2002)


Case<br />

Management<br />

... Help and assistance for seniors and those<br />

w who care for them


County of Erie<br />

Department of Senior Services<br />

Return to Nancy Schneider via mail, fax (858-6048) or e-mail.<br />

CAREGIVER REFERRAL<br />

A packet will be sent to the caregiver, including:<br />

Letter of introduction with Case Manager’s Name and phone number<br />

“Are You a <strong>Caregiver</strong>” brochure<br />

“Tips For <strong>Caregiver</strong>s“ brochure<br />

<strong>Caregiver</strong> <strong>Burden</strong> Assessment and return envelope<br />

Health Guide Record Book<br />

Magnetic Pen<br />

<strong>Caregiver</strong> Name: ___________________________________________<br />

Street: __________________________________________________<br />

City:<br />

Zip: ____________________<br />

Client Name: ______________________________________________<br />

[ ] Client has dementia - include additional brochure<br />

[ ] <strong>Caregiver</strong> is a Long Distance <strong>Caregiver</strong> - include additional brochure<br />

I have met or spoken to the <strong>Caregiver</strong> and they know the packet is in the mail.<br />

[ ] Yes [ ] No<br />

Case Manager<br />

_________________________<br />

I&R or Cluster Name<br />

___________________________


<strong>Caregiver</strong> <strong>Burden</strong> Assessment<br />

Are you “burning out” Answer these questions and receive helpful information.<br />

Since you began caregiving, how has assisting or having contact with the person for whom you care<br />

affected the following aspects of your life<br />

Do you have:<br />

a lot less<br />

a little less<br />

the same<br />

a little more<br />

a lot more….<br />

a lot<br />

less<br />

a little<br />

less<br />

the<br />

same<br />

a little<br />

more<br />

a lot<br />

more<br />

… time to yourself<br />

… stress in your relationship with your<br />

relative<br />

…personal privacy<br />

… attempts by your relative to manipulate<br />

y you<br />

… time to spend in recreational activities<br />

… unreasonable requests made of you by your<br />

relative<br />

… tension in your life<br />

… vacation activities and trips<br />

… nervousness and depression concerning your<br />

relationship with your relative<br />

… feelings that you are being taken advantage<br />

o of by your relative<br />

… time to do your own work and daily chores<br />

… demands made by your relative that are<br />

over and above what s/he needs<br />

… anxiety about things<br />

… time for friends and other relatives<br />

Score:<br />

OB =<br />

( >23 – Services)<br />

SB=<br />

( >13.5 - Counseling)<br />

DB=<br />

( >15 - Info)


SCORING SHEET<br />

CAREGIVER BURDEN ASSESSMENT<br />

Line up transparency with assessment page, record line score in last column, add pink,<br />

blue and green categories separately and enter totals in corresponding Score Box.<br />

Since you began caregiving, how has assisting or having contact with the person for whom you care<br />

affected the following aspects of your life<br />

Do you have:<br />

a lot less<br />

a little less<br />

the same<br />

a little more<br />

a lot more….<br />

…time to yourself<br />

… stress in your relationship with your<br />

relative<br />

…personal privacy<br />

… attempts by your relative to manipulate you<br />

… time to spend in recreational activities<br />

… unreasonable requests made of you by your<br />

relative<br />

…tension in your life<br />

… vacation activities and trips<br />

… nervousness and depression concerning your<br />

relationship with your relative<br />

… feelings that you are being taken advantage<br />

of by your relative<br />

… time to do your own work and daily chores<br />

… demands made by your relative that are over<br />

and above what s/he needs<br />

… anxiety about things<br />

… time for friends and other relatives<br />

Score Boxes:<br />

a lot<br />

less<br />

5<br />

1<br />

5<br />

1<br />

5<br />

1<br />

1<br />

5<br />

1<br />

1<br />

5<br />

1<br />

1<br />

5<br />

a little<br />

less<br />

OB: SB: DB:<br />

4<br />

2<br />

4<br />

2<br />

4<br />

2<br />

2<br />

4<br />

2<br />

2<br />

4<br />

2<br />

2<br />

4<br />

the<br />

same<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

3<br />

a little<br />

more<br />

2<br />

4<br />

2<br />

4<br />

2<br />

4<br />

4<br />

2<br />

4<br />

4<br />

2<br />

4<br />

4<br />

2<br />

a lot<br />

more<br />

1<br />

5<br />

1<br />

5<br />

1<br />

5<br />

5<br />

1<br />

5<br />

5<br />

1<br />

5<br />

5<br />

1<br />

Score


Erie County Department of Senior Services<br />

<strong>Caregiver</strong> Resource Center<br />

95 Franklin St., Room 1301, Buffalo, NY 14202<br />

<strong>Caregiver</strong>: __________________________________________________<br />

<strong>Caregiver</strong> <strong>Burden</strong> Assessment<br />

Scoring Sheet<br />

Objective <strong>Burden</strong>: Is defined as how a caregiver feels that providing help and<br />

assistance disrupts the caregiver’s own life. <strong>The</strong> caregiver is likely to benefit from<br />

services that will lessen tasks or care responsibilities, such as in-home services or<br />

adult day programs.<br />

Scores range from 6 to 30. Scores above 23 could be viewed as quite high.<br />

Score:___________<br />

Subjective Stress <strong>Burden</strong>: Is the emotional impact of caregiving responsibilities on<br />

the caregiver. A caregiver who is emotionally stressed may benefit from a support<br />

group or individual counseling.<br />

Scores range from 4 to 20. Scores above 13.5 could be viewed as quite high.<br />

Score:___________<br />

Subjective Demand <strong>Burden</strong>: Is defined as the extent to which the caregiver feels<br />

care responsibilities are overly demanding. <strong>The</strong> caregiver who is most stressed<br />

because he or she believes the demands made by the care recipient are<br />

inappropriate or excessive, may best be helped by an opportunity to learn more<br />

about the disease process, a care recipients true level of dependency and how much<br />

help should be provided. Written information about the disease, including how<br />

others cope, or talking with a professional - such as a counselor - can be good<br />

sources of help.<br />

Scores can range from 4 to 20. Scores above 15 could be viewed as quite high.<br />

Score:____________


Objective<br />

<strong>Burden</strong>…<br />

disruption of the caregiver’s life<br />

Measures:<br />

• amount of personal privacy one<br />

retains<br />

• time available for recreational<br />

activities<br />

• restrictions on vacations and trips<br />

amount of time available to do one’s<br />

own work and daily chores<br />

• amount of time for friends and<br />

relatives


What might help<br />

• home care<br />

• adult day care<br />

• friendly visiting<br />

• home delivered meals<br />

• assistive equipment<br />

• PERS


SUBJECTIVE<br />

STRESS<br />

BURDEN…<br />

the emotional impact of caregiving<br />

Measures:<br />

• stress in the relationship with the<br />

c care recipient<br />

• tension in the caregiver’s life<br />

• nervousness and depression<br />

rrelated to the relationship with the<br />

ccare recipient<br />

• anxiety


Research conducted at New York<br />

University Medical School showed<br />

that a program that combines<br />

counseling and social support can<br />

reduce the stress felt by<br />

caregivers of Alzheimer patients<br />

in response to their loved ones<br />

behavior problems, even when such<br />

behaviors increase in frequency<br />

and severity.<br />

Source: Tufts University Health & Nutrition Letter<br />

March 2004


What might help<br />

• support groups<br />

• professional counseling


SUBJECTIVE<br />

DEMAND<br />

BURDEN…<br />

how the caregiver perceives care<br />

responsibilities to be overly demanding<br />

Measures:<br />

• attempts by the care recipient to<br />

manipulate the caregiver<br />

• unreasonable requests of the<br />

caregiver<br />

• feelings by the caregiver of being<br />

taken advantage of by the care<br />

recipient<br />

• demands made by the care recipient<br />

that are over and above what is<br />

needed


What might help<br />

• learning more about the<br />

ddisease process<br />

• professional counseling


Erie County Department of<br />

Senior Services<br />

<strong>Caregiver</strong> Resource Center<br />

<strong>Caregiver</strong> <strong>Burden</strong> Assessment<br />

Created by:<br />

Miriam R. Callahan<br />

&<br />

Lisa M. Rood<br />

March 2004

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