Your History as a Caregiver

1. How long have you been a caregiver?

0 – 3 months
4 – 12 months
1 – 5 years
> 5 years - answer question 1a

1a - Number of years you have been a caregiver (6 - 70)

2. You are the caregiver for

a parent
a child
a spouse/life partner
a family member or friend
none of the above

3. Age of the person you are caring for

0 – 5 years
6 – 10 years
11 – 18 years
19 – 30 years
31 – 65 years
66 – 75 years
76 – 85 years
85 and older

4. Type of disability (check all that apply):

4a - Specify other condition

5. Do you currently have formal support (respite care, paid housekeeping or homecare, other professional services, etc) for helping you with caregiving?

Yes
No

6. Do you currently have informal support (family, friends, other unpaid services) for helping you with caregiving?

Yes
No

Alberta Caregiver College

Your History as a Caregiver

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