Arizona Myeloma Network

Cancer Caregivers Survey

We welcome your caregiver story and have the below form available that you can fill out which will submit your story to us. You can use your name if you like but it is not required. We will put the information together and share the ‘results’ both on our website and in the Book. It is an opportunity to learn from you what has helped you on your caregiver journey and suggestions for how we can improve services and programs.

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Cancer Caregivers Survey

Questions can be answered as written or used as guidelines for relating the caregiving experience. Not all of the questions may be appropriate to an individual’s caregiving situation.

Questions:

Caregiver Name(optional) [full name or first name and last initial]:

1. What was the cancer diagnosis (type of cancer)?

2. Describe your feelings when you became aware of the diagnosis.

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3. At what stage in the patient’s cancer journey did you become a caregiver? Please include your relationship (spouse, relative, friend, co-worker, etc.).

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4. What were some of the immediate changes (relationships, daily living) that occurred?

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5. Describe your main caregiving roles, tasks, and expectations.

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6. What were some of the challenges you faced? (provide 2-3 examples, max)

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7. How did the diagnosis and caregiving experience change your relationship with the patient (at the onset and over the course of treatment)?

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8. What do you wish you’d known when you started this journey?

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9. What resources were most helpful to you?

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10. What advice would you give to another caregiver?

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