Caregivers Count Too! Section 4: Examples of Caregiver Assessment Tools

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The publications below are available as a downloadable PDF document. To view and print this file you will need Adobe Acrobat Reader. It is available as a free download by clicking here.


California uses a distinct assessment tool within a state-funded caregiver support program (the statewide system of 11 California Resource Centers) to examine the needs/situations of family caregivers to aid in care planning and service development. Click  here to download the full assessment tool.


Massachusetts is examining a uniform assessment process for Medicaid Home and Community-Based Services (HCBS) by piloting the use of a new caregiver assessment component. The assessment tool has not yet been tested for reliability or validity. This component identifies the primary family caregiver as a distinct consumer in the HCBS system, integrating family caregiver support into a broader systems framework. Click here to download the full assessment tool.


Minnesota includes a caregiver assessment as part of the state’s uniform assessment process to access publicly funded long-term care services. Click here to download the Minnesota Long Term Care Consultation Services Assessment Form.


Pennsylvania uses a uniform assessment process with a caregiver component for all publicly funded programs for older people and their families. Click here to download the Comprehensive Options Assessment Form. 


Washington includes a caregiver component as part of the state’s uniform assessment tool for all HCBS programs for older people and adults with disabilities. Currently state officials are working toward enhancing the tool to include a comprehensive family caregiver assessment. Click here to download  the full assessment tool.

Other – American Medical Association (AMA)

The AMA has developed and tested an 18-item Caregiver Self-Assessment Questionnaire to encourage physicians and health practitioners to recognize and support family caregivers. Click here to download the full assessment tool.


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