Caregiver Strain Index

Thirteen yes-or-no questions put to the caregiver. The high-strain threshold is 7 points out of 13.

Updated 1 Sep 2026 · Methodology

The questions are put to the caregiver, not the patient. Each «yes» scores one point and the high-strain threshold is 7 points.

1. Sleep is disturbed

for example, the person gets up or wanders the house at night

2. It is inconvenient

helping takes a lot of time, or it takes long to get there

3. It is a physical strain

lifting the person, getting them out of a chair

4. It is confining

helping limits free time or makes visits impossible

5. There have been family adjustments

helping has disrupted the routine, or there is no privacy

6. There have been changes in personal plans

a job had to be turned down, or a holiday was not possible

7. There have been other demands on my time

from other family members

8. There have been emotional adjustments

for example, because of severe arguments

9. Some behaviour is upsetting

incontinence, memory trouble, accusing others of taking things

10. It is upsetting to see how much the person has changed

they are a different person from before

11. There have been work adjustments

time had to be set aside for helping

12. It is a financial strain

13. It is completely overwhelming

from worry about the person, or about how to continue treatment

About this calculator

The instrument rates the burden not on the patient but on whoever cares for them, and the questions are put to the caregiver. Thirteen items cover sleep, physical effort, loss of freedom, changes in the family and at work, emotional changes, money and the sense of being overwhelmed. Each «yes» scores a point and the high-strain threshold is 7. The Spanish validation by López Alonso and Moral Serrano in 2005 showed internal consistency of 0.808 and an area under the curve of about 0.79 for depression and 0.81 for anxiety in the caregiver. Its practical value is that the index is short enough to administer in an ordinary consultation, whereas longer burden scales rarely reach primary care at all. The limits follow from its construction. The index measures reported strain, not the need for any particular service: a high score says the person is struggling, but not whether they need a home carer, a day hospital or a conversation with a psychologist. Nor does it separate the source of the strain: the same 8 points turn up in someone caring for a person with dementia and in someone caring after a stroke, and the help those two need is different.

Source

Robinson BC. Validation of a Caregiver Strain Index. J Gerontol 1983;38(3):344-348. Испанская валидация: López Alonso SR, Moral Serrano MS. Validación del Índice de Esfuerzo del Cuidador en la población española. Enfermería Comunitaria 2005;1(1):12-17.

Formula version: robinson-1983-lopez-2005-v1

Calculators

Goldberg Anxiety and Depression ScaleTwo nine-item subscales with a screening filter of the first four questions. Thresholds: anxiety 4 points, depression 2 points.
Barthel IndexBasic activities of daily living across ten items, 0 to 100 points. Baztán thresholds: under 20 total dependence, 100 independence.
Lawton-Brody IADL ScaleInstrumental activities of daily living: eight items scored 0 or 1. Complements the Barthel Index at the upper end of function.
Pfeiffer Short Portable Mental Status QuestionnaireTen-question cognitive screen. Errors are counted and the threshold shifts with an education adjustment.
Geriatric Depression Scale, 15-item (GDS-15)Fifteen yes-or-no questions with no somatic items. Screening threshold 5 points.

About this calculator

Source

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