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AGING AND LONG-TERM SUPPORT ADMINISTRATION

TCARE® Personal Caregiver Survey

This link is for Washington State caregivers who have contacted their local Family Caregiver Support Program and been directed to fill out a Personal Caregiver Survey.

The Personal Caregiver Survey asks you to reflect on your experiences and rate your response to a series of statements based on identified rating scales in each section.   

This survey is used to help you and the caregiver specialist get a better understanding of your situation and staff to better define an individualized plan to meet your unique needs.

If you haven’t been in touch with your local Family Caregiver Support Program, you will want to contact them first.  Learn more about what the Family Caregiver Support Program is or find the local telephone number

Filling out a Personal Caregiver Survey

There are two ways you can complete the Personal Caregiver Survey.

  1. Over the phone with a caregiver specialist asking you the questions and filling in your responses as you complete the survey.
  2. By downloading it below.

You can print a copy and fill it out by hand or type your answers in the Survey on your computer.  If you fill the Survey out on your computer, print it out once you’re done. You will need to make arrangements with your caregiver specialist to get him or her a copy of your completed survey.

The Tailored Caregiver Assessment and Referral (TCARE®) ) Personal Caregiver Survey  was developed by Rhonda Montgomery Ph.D. at the University of Wisconsin and colleagues.