Prepared by ARCH as a sample measurement tool for Lifespan Respite grantees/partners.

List each agency being tracked in the left hand column. Include your own if applicable.

How to count the number of caregivers who requested respite:

  • Count caregivers who are on a waiting list for services.
  • Count caregivers who requested services during the reporting period whether or not they have started receiving services.
  • Count caregivers who may have first requested services in an earlier time period and are now receiving respite. Provided they continue to desire the service they should be counted here.

How to count the number of caregivers who received respite services:

  • Count any caregiver who received respite services as a result of your agency’s efforts at any time during the reporting period.

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