Zarit Caregiver Burden Assessment (12-item)
The following is a list of statements that reflect how people sometimes feel when taking care of another person. After reading each statement, indicate how often you experience the feelings listed by choosing the answer that best corresponds to the frequency of these feelings. Please note: "relative" refers to the person you are caring for, regardless of relationship.
Name
*
First Name
Last Name
Email
*
example@example.com
1. Do you feel you don't have enough time for yourself?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
2. Do you feel stressed between caring and meeting other responsibilities?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
3. Do you feel angry when you are around your relative?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
4. Do you feel your relative affects your relationship with others in a negative way?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
5. Do you feel strained when you are around your relative?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
6. Do you feel your health has suffered because of your involvement with your relative?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
7. Do you feel you don't have as much privacy as you would like, because of your relative?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
8. Do you feel your social life has suffered because you are caring for your relative?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
9. Do you feel you have lost control of your life since your relative's illness?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
10. Do you feel uncertain about what to do about your relative?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
11. Do you feel you should be doing more for your relative?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
12. Do you feel you could do a better job in caring for your relative?
*
Never
Rarely
Sometimes
Frequently
Nearly Always
Michel Bédard, PhD,1,2 D. William Molloy, MB,3 Larry Squire, MA,1 Sacha Dubois, BA,3 Judith A. Lever, MSc(A),4 and MartinO’Donnell, MRCP(I)3 The Gerontological Society of America Vol. 41, No. 5, 652–657 The Gerontologist The Zarit BurdenInterview: A New Short Version and Screening Version
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