Track relevant outcomes using low- burden instruments in the public domain such as the (texasbreastreduction.com texasbreastreduction.com), the Columbia Impairment Scale for .org/ wp - content / uploads /AEVIDENCE-BASED-PRACTICEpdf. Caregiver Burden Scale. Caregiver's name: _. Date: _. The following questions reflect how people sometimes feel when they are taking care of another person. ORDER FORM – Burden Scale for Family Caregivers often need their family to take care of them, and family caregivers experience more caregiving burden.