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Home Care Assessment Quiz
Our leadership team is proud to help you navigate your home care journey!
Medical Conditions
Does your loved on have a medical diagnosis that is impacting his or her ability to stay safely at home?
No
Yes, but my loved one is still mostly independent
Yes, my loved one is strongly impacted by an illness or disability
Does your loved one have one or more of the following diagnoses, illnesses, or injuries?
Stroke
Diabetes
Parkinson's disease
Dementia/Alzheimer's disease
Mild cognitive impairment
Any degenerative illness with active symptoms
Loss of mobility or use of limbs
Blindness
None
Cognitive Condition
Is your loved one experiencing cognitive decline?
No, sharp as a tack
No, just a little forgetfulness here and there
Yes, but my loved one manages it pretty well
Yes, my loved one does not make consistently good decisions without direction
My loved one is cognitively fine but some companionship would be really great
My loved one needs help throughout the day but sleeps through the night
Ambulation – Getting Around
Does your loved one need help getting in and out of chairs or bed?
No, my loved one manages just fine
No, but it is slow going
Yes, especially first thing in the morning or later in the day
Yes, my loved one requires assistance with every transfer
My loved is bed ridden
How many falls has your loved one had in the last 3 months?
0
1
2-3
More than three
Medications
What level of medication support does your loved one need?
My loved one self manages medications
Someone else puts pills in a pillbox but my loved one usually remembers to take them daily
My loved one needs daily reminders to take medications as prescribed
My loved one needs medication reminder and depends on medications several times a day
Meals
Select all that apply to your loved one:
My loved one doesn’t need any help with meals
My loved one would love help with the occasional hot meal
My loved one has lost visible weight in the last 6 months and we are worried about nutrition
My loved one is 100% dependent on others for nutrition
Transportation
My loved one needs the following level of transportation support:
None, my loved one drives
My loved one still drives but it would be better if someone else drives
My loved one doesn’t drive but only needs help 1-3 times a week with transportation
My loved one needs almost daily transportation support
My loved one will not use transportation services
Cleaning Support
My loved one needs help with cleaning:
Never, my loved one takes care of house hold chores or there is a cleaning service
Sometimes, a little help with laundry, linens, and tidying up would be great
My loved one needs daily help to clean up after meals or manage daily waste
Personal Care
How much help does your loved one need with showering?
None, my loved one is independent
Standby assist, my loved one can wash but has trouble getting in and out of a slippery tub now and then
My loved one requires help in the shower with washing and personal cleanliness
My loved one relies completely on other for daily personal care and hygiene
Time is Up!
Green Tree Home Care - 9466 Cuyamaca Street #102, Santee, CA 92071
800-518-9277