Relationship Issues Assessments

As with a number of caregiver challenges, the role of relationships within the context of caregiving can be conceptualized as something that increases caregiving burden/stress, or is actually an outcome of caregiving burden/stress (Bass et al., 1988; Lawrence et al., 1992; Pearlin et al., 1990; Semple, 1992; Strawbridge, 1991; Whitlatch, et al., 2001).  Furthermore, there are various relationships can be examined – caregiver and care recipient; caregiver and informal supports (family/friends); caregiver and formal supports; caregiver and employer.  Fortunately, there have been a number of instruments developed to capture the varying nature of the relationships and relationship issues.

Caregiving Burden Scale

  • Measures two domains: quality of the caregiver-care recipient relationship, and the consequences of caregiving.
  • 13 items (5-point scale)
  • Gerritsen, J. C., & van der Ende, P. C. (1994). The development of a caregiving burden scale. Age and Ageing, 23, 483-491.

Closeness of the Relationship

  • Measures caregiver’s perception of the closeness of the relationship between the caregiver and the care recipient.
  • 6 items (4-point scale)
  • Whitlatch, C. J., Schur, D., Noelker, L. S., Ejaz, F. K., & Looman, W. J. (2001). The stress process of family caregiving in institutional settings. The Gerontologist, 41, 462-473.

Dyadic Adjustment Scale

  • Measure of marital adjustment that has both partners rate the extent to which they agree or disagree with a range of issues.  The instrument also measures the frequency with which the couple engage in interactions such as arguing or confiding in each other.
  • 32 items (3-point, 5-point, 6-point scales)
  • Spanier, G. B. (1977). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage & the Family 38, 15-28.

Family Adaptability and Cohesion Evaluation Scale

  • Measures family cohesion and flexibility. Tool not designed specifically for caregivers.
  • 30 items (5-point scale)
  • Olsen, D., Portner, J., & Bell, R. Q. (1982). FACES II: Family Adaptability and Cohension Scales. Minnesota: University of Minnesota.

Family Assessment Device

  • Evaluates families according to 7 domains: problem solving, communication, roles, affective responsiveness, affective involvement, behaviour control, and general functioning.
  • 53 items (4-point scale)
  • Epstein, H. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9, 171-180.

Family Conflict

  • Measures disagreement concerning treatment of the care recipient.
  • 12 items (4-point scale)
  • Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583-594.

Family Conflict

  • Measures conflict among caregivers who institutionalize their relatives.
  • 8 items (4-point scale)
  • Semple, S. J. (1992). Conflict in Alzheimer’s caregiving families: Its dimensions and consequences. The Gerontologist, 32, 648-655.

Family Conflict Scales

  • Measures conflict around the family’s definition of the illness and strategies for acre, attitudes and actions toward the care recipient, and actions and attitudes toward the caregiver.
  • 12 items (4-point scale)
  • Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583-594.

Family Hardiness Index

  • Measures hardiness in relation to 4 domains: co-oriented commitment, confidence, challenge, and control.
  • 20 items (4-point scale)
  • McCubbin, M. A., McCubbin, H. I., & Thompson, A. I. (1987). Family Hardiness Index. In H. I. McCubbin & A. I. Thompson (Eds.), Family Assessment Inventories (pp. 123-130): The University of Wisconsin-Madison.

Family Relationship Strain

  • Measures strain within the family as perceived by both the caregiver and care recipient.
  • 5 items (4-point scale)
  • Bass, D. M., Tausig, M. B., & Noelker, L. S. (1988). Elder impairment, social support and caregiver strain: A framework for understanding support’s effects. The Journal of Applied Social Sciences, 13, 80-115.

Inconveniences in Living Arrangements

  • Measure the level of potential inconveniences in living arrangements in the caregiving household in relation to food, social life, leisure activities, employment, household chores, expenses, privacy, and child care.
  • 8 items (5-point scale)
  • Midel, C. H., & Wright, R. (1982). Differential living arrangements among the elderly and their subjective well-being. Activities, Adaptation & Aging, 3, 25-34.

Loss of Intimate Exchange

  • Measures the extent to which caregivers feel they have experienced a loss of closeness and intimacy because of a decline in the care recipient.
  • 3 items (4-point scale)
  • Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583-594.

Quality of the Caregiver – Care Recipient Relationship

  • Measures the quality of the current relationship in relation to general closeness, communication, similarity of views about life, and degree of getting along.
  • 4 items (4-point scale)
  • Lawrence, R. H., Tennstedt, L. L., & Assmann, S. F. (1998). Quality of the caregiver-care recipient relationship: Does it offset negative consequences of caregiving for family caregivers? Psychology and Aging, 13, 150-158.

Relational Deprivation

  • Measures the extent to which the caregiver feels separated from parts of their lives that had previously been supported by or shared with the care recipient.
  • 6 items (4-point scale)
  • Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583-594.

Social Interaction Measure

  • Measures positive aspects of care recipient behaviour such as cooperation, friendliness, and enjoyable to be with.
  • 5 items (4-point scale)
  • Bass, D. M., McCarthy, C., Eckert, S., & Bichler, J. (1994). Differences in service attitudes and experiences among families using three types of support services. The American Journal of Alzheimer’s Care and Related Disorders & Research, May/June.

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