Beginning Again: Pre-Session Survey (Caring Our Way)

Before joining us, tell us about your current situation.

Question Title

* 1. On a scale from 1 to 5, with 1 being the least stressed and 5 being the most stressed, how stressed are you?

1 Least stressed

2

3

4

5 Most stressed

1 Least stressed

2

3

4

5 Most stressed

Question Title

* 2. I have regrets about my caregiving experience.

1 True

2

3

4

5 Not true

1 True

2

3

4

5 Not true

Please share any additional comments.

Question Title

* 3. I don’t have a plan for my next steps.

1 True

2

3

4

5 Not true

1 True

2

3

4

5 Not true

Please share any additional comments.

Question Title

* 4. I don’t know how to talk about my caregiving experience.

1 True

2

3

4

5 Not true

1 True

2

3

4

5 Not true

Please share any additional comments.

Question Title

* 5. I worry I won’t have another purpose.

1 True

2

3

4

5 Not true

1 True

2

3

4

5 Not true

Please tell us more.

Question Title

* 6. When did your caregiving experience end?

Less than three months ago.

Between three and six months ago.

Between six months and one year ago.

Between one year and 18 months ago.

Between 18 months and two years ago.

More than two years ago.

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