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Northeast Missouri Area Agency on Aging » Rapid Caregiver Well Being Response Scale

Rapid Caregiver Well-Being Response Scale

Providing care for another person can be extremely rewarding in many ways, but many challenges go along with being a caregiver. NEMO AAA and its partners at Saint Louis University want to help you navigate the caregiver role and recognize the importance of caring for yourself while supporting the person you are caring for.

The Rapid Caregiver Well-Being Scale (R-CWBS) focuses on the caregiver’s strengths and ability to meet their basic needs and satisfaction with daily living. If you are a caregiver needing assistance, completing the R-CWBS can help our staff better understand your met and unmet needs to provide you with the most comprehensive information and assistance.

Upon completing and submitting the Rapid Caregiver Well-Being Scale, our staff will make contact with you within two business days to discuss your needs and provide you with resource information.

If you are needing emergency assistance, please call 9-1-1. This is not a behavioral health referral.
Please be assured that your responses are kept confidential.

This scale indicates to what extent you think each activity mentioned has been met in a timely way.

Give us your feedback to help us serve you better. https://phelpshealth.org/rapid-caregiver-well-being-scale

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Name*
Sex*

Activities

Below are listed activities that each of us do or someone does for us. Thinking over the past three months, indicate to what extent you think each activity has been met by circling the appropriate number on the scale provided below. You do not have to be the one doing the activity. You are being asked to rate the extent to which each activity has been taken care of in a timely way. 1. Rarely 2. Occasionally 3. Sometimes 4. Frequently 5. Usually
Taking care of personal daily activities (meals, hygiene, laundry)
Taking time to have fun with friends and/or family*
Treating or rewarding yourself*

Needs

Below are listed needs we all have. For each need listed, think about your life over the past three months. During this period of time, indicate to what extent you think each need has been met by circling the appropriate number on the scale provided below. 1. Rarely 2. Occasionally 3. Sometimes 4. Frequently 5. Usually
Receiving appropriate health care*
Feeling good about yourself*
Feeling secure about your financial future*
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