Caregiver Support and Well-Being Priority Project - Central East ...
Caregiver Support and Well-Being Priority Project - Central East ...
Caregiver Support and Well-Being Priority Project - Central East ...
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Appendix 4<strong>Caregiver</strong> <strong>Support</strong> <strong>and</strong> <strong>Well</strong>being <strong>Priority</strong> <strong>Project</strong>Identification of <strong>Caregiver</strong> NeedsKindly take a few moments to fill in this questionnaire. If you need more space, use the back of page.I live in _________________________(please indicate, city,town or area in which you live)I am a caregiver for my_______ spouse_______ child_______ parent_______ extended familyI have been caregiving for:_______ less than 6 months_______ 6 months – 5 years_______ 5-10 years_______ more than 10 years_______ friend_______ otherWhat are the top 3 things which you need to help you in your caregiving role?63