Are you caring for a loved one?

News of terminal or life-limiting illness may come unexpectedly. You may feel the overwhelming need to carry the burden of the responsibilities needed to care for your loved one, leaving you spread too thin. EverHeart Hospice offers support so you can find peace — when you can’t do it all — allowing you to cherish the moments with your loved one.

Call 800.417.7535 option 2 or answer our simple questions to see if you could benefit from extra support.

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Caregiver Questionnaire

Thank you for taking the time to complete this questionnaire. As a caregiver, your well-being is crucial in providing the best care for your loved one. This questionnaire aims to determine if you could benefit from one of our services. Please answer “yes” or “no” to the following questions.

1 Do you feel a high level of stress related to caregiving responsibilities?

2 Do you spend the majority of your day providing care for your loved one?

3 Are you experiencing any physical symptoms such as fatigue, headaches, or sleep disturbances due to caregiving duties?

4 Do you feel overwhelmed or isolated in your caregiving role frequently?

5 Have you had to make significant sacrifices in your personal or professional life due to caregiving responsibilities?

6 Are you unable to take regular breaks or time for self-care while fulfilling your caregiving duties?

7 Have you noticed any changes in your emotional well-being since taking on the role of caregiver?

8 Are you finding it challenging to manage medications, appointments, or other medical aspects of care for your loved one?

9 Have you experienced any difficulties in communicating with healthcare professionals regarding your loved one's care needs?

10 Do you lack adequate support in your caregiving role from family, friends, or other support networks?


Total the number of questions answered “yes”.

If the total score is 6 or higher, it indicates a significant level of stress and responsibility, suggesting that hospice support may be beneficial.

Thank you for completing this questionnaire. If your score indicates high levels of stress and responsibilities, we encourage you to reach out to EverHeart Hospice to see if we can help. Remember, taking care of yourself is essential in providing quality care and giving you the most quality time with your loved one.

finding peace

“Hospice had taken over the role of the caregiver so I could just be the mother, and I laid there holding my daughter and felt peace…”

— Kristi Strawser

Holistic care

Our patient and family-centered care team identify physical, emotional, cognitive, and spiritual needs during this difficult time. Our team’s special care allows you to spend more quality time with family, creating treasured memories to cherish forever.


Nurses assess our patients’ and families’ needs, provide education on medications and the disease process, and care for the whole person.


Social workers provide emotional and psychological support to the patient and family and assist by finding resources they need.


Chaplains offer emotional, psychological, and non-denominational spiritual support.