Collaborators/Partners Fulfillment of Agreement Matrix

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Prepared by ARCH as a sample measurement tool for Lifespan Respite grantees/partners. In the far left hand column, list each agency the Lifespan Respite program collaborates with and has an…

Increase in Caregiver Access to Respite (2)

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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…

Increase in Caregiver Access to Respite

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Prepared by ARCH as a sample measurement tool for Lifespan Respite grantees/partners.  In an interview or focus group format, ask each key leader or stakeholder, “Have you documented an increase…

VA Lifespan Respite Voucher Program Satisfaction Survey

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As part of the Virginia Lifespan Respite Voucher Program, caregivers are required to fill out this brief Satisfaction Survey and submit it to the Department for Aging and Rehabilitative Services…

Caregiver Survey from Tennessee Respite Coalition

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Example of a caregiver survey from Tennessee Respite Coalition to measure the outcomes of respite care.

Caretaker Intake Form from Nevada Care Connection

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ID Family Caregiver Navitor Caregiver Retrospective Survey

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Survey from Idaho Family Caregiver Alliance – Family Caregiver Navigator

COVID-19 Oath of Personal Responsibility

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We have composed a simple “Oath of Personal Responsibility” that all respite agency staff, respite providers, family caregivers, and care recipients should adhere to. While not legally binding, it does…

COVID-19 Competency Validation Checklist

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COVID-19 Health Screening Policy and Procedure

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Before conducting any respite service, a health screening will be completed based on the county health department recommendations for safe reopening. This screening will occur anytime a provider, client, or…