[x] = person being cared for e.g. husband or wife. |
(A) CURRENT CARING SITUATION
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Q1
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Do you have any needs or concerns about caring for your [x]? |
Q2
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Do you need any information about the condition your [x] has and how the care needed might change over time? |
Q3
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Do you need any help to provide any of the physical or general daily care your [x] requires? |
Q4
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Do you need any help to provide any emotional or spiritual care your [x] requires? |
Q5
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Do you have a named person to call in an emergency or out-of-hours to discuss any concerns about your [x]? |
(B) CARER’S HEALTH AND WELL-BEING
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Q6
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Do you feel involved in discussions and listened to by professionals about the care needed by [x]? |
Q7
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Do you need any help or information about money or legal issues? |
Q8
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Do you need a break from caring during the day or overnight? |
Q9
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Do you need any help to balance your own needs with the demands of caring? (e.g. attend own health appointments, social activities) |
Q10
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If appropriate include: Do you know your [x]’s wishes and preferences for EoL care? (If known, have they been written down and shared, e.g. advance care planning (ACP) doc?) |