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Compassion. Advice. Support. 

Office Hours 8:00am – 5:00pm Monday to Saturday  (AEST)
Vet Consulting Hours 8:00am – 8:00pm 7 days

Home Euthanasia and End of Life Care 

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Caregiver Burden & QOL Assessment Form

Caring for a pet who is unwell can have impacts on our own wellbeing, with many caregivers experiencing moments of overwhelm, exhaustion or distress, at certain times, throughout the journey.

If your vet has asked you to complete this assessment form, we encourage you to think about how you and your family are feeling during this time.

The following is a list of statements that reflect how people sometimes feel when taking care of their pet. After reading each statement, please indicate how often you experience the feelings described, by circling the number that best corresponds to the frequency of those feelings.

As time goes on and your pet’s care requirements increase, you may need to repeat the evaluation. It is often useful to fill out the assessment form every few days and record your results over an extended period. We have provided logs for you to do this for as long as you feel appropriate. In some cases, this process will give you reassurance that you are managing ok, whilst in others it may help you realise you need to make some changes, seek additional support, or consider different care choices for you and your pet. Your wellbeing is important and support is available.

Access a printable version of the Sunset Vets Caregiver Burden Quality of Life Assessment Worksheet HERE

Caregiver Burden Quality of Life Assessment Worksheet

1. Do you feel you don’t have enough time for yourself because of the time you spend caring for your pet?

0      1      2      3      4

2. Do you feel stressed between taking care of your pet and trying to meet other responsibilities for your family or work?

0      1      2      3      4

3. Do you feel embarrassed by your pet’s behavior?

0      1      2      3      4

4. Do you get angry when you are around your pet?

0      1      2      3      4

5. Do you feel that your pet currently negatively affects your relationship with other family members or friends?

0      1      2      3      4

6. Are you afraid of what the future holds for your pet?

0      1      2      3      4

7. Do you feel tense when you are around your pet?

0      1      2      3      4

8. Do you feel that your health has been affected because of your involvement with your pet?

0      1      2      3      4

9. Do you feel that your social life has been affected because you are taking care of your pet?

0      1      2      3      4

10. Do you feel uncomfortable having friends over because of your pet?

0      1      2      3      4

11. Do you feel that you don’t have enough money to take care of your pet in addition to the rest of your expenses?

0      1      2      3      4

12. Do you feel that you won’t be able to take care of your pet for much longer?

0      1      2      3      4

13. Do you feel that you have lost control of your life since your pet’s illness?

0      1      2      3      4

14. Would you prefer to leave the care of your pet to someone else?

0      1      2      3      4

15. Do you feel uncertain about what to do regarding your pet?

0      1      2      3      4

16. Do you think you should do more for your pet?

0      1      2      3      4

17. Do you think you could take better care of your pet?

0      1      2      3      4

18. Overall, to what extent do you feel overwhelmed in taking care of your pet?

0      1      2      3      4

Today's Score

A score above 18 = indicative of clinically significant caregiver burden.

0 – 18     Little or no burden
19 – 36   Mild to moderate burden
37 – 54   Moderate to severe burden
55 – 72   Severe burden