There has been controversy in the literature regarding the relationship between the caregiver’s strain and his or her ability to make an assessment of the physical needs and health care status of the care recipient . Researchers such as Pruchno and colleagues (1997) have suggested that caregivers who are extremely burdened or depressed may perceive the care recipient to be more impaired than he or she actually is. Alternatively, Bookwala and Schulz (1998) found that caregiver mastery and level of neuroticism played a role in how the caregiver’s perception of care recipient impairment affected his or her strain..