This checklist can help families determine what resources might be appropriate now and help prepare for the future. For further help, consult a physician, geriatric-care manager, county social service department of other professionals.
What Help is Needed?
For each task below, check the one description that best fits the situation of the person you are concerned about. Add the numbers to get a score. Then find the recommendation for that score in the accompanying guide.
Maintain Home/Lawn:
- Without assistance (1)
- With some assistance (2)
- Needs total assistance (3)
- Lives in apartment or other maintained housing (1)
Does Housekeeping/Laundry:
- Without help (1)
- With some help or reminding (2)
- Needs total assistance (3)
- Hires outside agency (1)
Recognizes Strangers:
- Able to recognize strangers and seek help (1)
- Unable to recognize strangers or seek help (2)
Handling Emergencies:
- Independently able to get emergency help (1)
- Needs guidance and instruction (2)
- Unable to get emergency help (3)
Driving:
- Drives or is able to use public transportation (1)
- Doesn’t drive or needs help with transportation (2)
- Needs special van for transport (3)
Social Activities:
- Independently arranges and attends social activities (1)
- Needs help making social arrangements and getting transportation (2)
- Unable to participate in social activities with out direct help (3)
Managing Finances:
- Independently manages finances (1)
- Needs some help (reminding, writing out checks, reviewing mail) (2)
- Unable to manage finances (3)
Getting Groceries:
- Able to get or arrange for groceries (1)
- Needs Help (2)
- Unable to get groceries (3)
Preparing Meals:
- Prepares meals without assistance (1)
- Needs help (2)
- Unable to prepare meals (3)
Eating:
- Feeds self without help (1)
- Needs supervision or reminders (2)
- Unable to feed self (3)
Recognizing Surroundings:
- Always alert and oriented to date, time and place (1)
- Intermittently confused about time and place (2)
- Consistently confused about time and place (3)
Keeping Appointments:
- Able to set and keep appointments (1)
- Needs reminding (2)
- Needs help to set appointments (3)
Following Directions:
- Able to understand and follow directions (1)
- Needs to check directions several times before understanding (2)
- Unable to follow directions even with supervision (3)
Wandering:
- Does not wander (1)
- Wanders or has gotten lost (3)
Personal Care:
- Independently manages hygiene, brushing teeth, nail care, shaving, hair care (1)
- Needs reminders to maintain grooming and appearance (2)
- Needs help to complete grooming (3)
Dressing:
- Gets dressed independently (1)
- Needs reminders to choose clothing and dress (2)
- Needs help to dress (3)
Bathing:
- Independently bathes or showers (1)
- Needs standby help or supervision (2)
- Needs help to bathe (3)
Continence:
- Continent of bowel and bladder, or use of incontinence products independently (1)
- Needs reminding to use toilet, or help using incontinence products (2)
- Unable to use toilet independently (3)
Gait:
- Walks or moves independently (with or without cane, walker or wheelchair) with no falling (1)
- Has unsteady gait and has fallen in past 6 months (2)
- Needs help to walk or maneuver wheelchair (3)
Transferring:
- Independently transfers to bed, chair or toilet (1)
- Needs help to transfer (3)
Medical/Rehab Therapy:
- No need for medical or rehabilitative therapy (1)
- Has medical needs or therapies and manages them independently (1)
- Needs intermittent help managing medical needs (2)
- Needs medical monitoring (3)
Medications:
- Needs no help identifying and taking medications (1)
- Needs help or reminders to take medications (2)
- Unable to manage medications (3)
Scoring the Evaluation – What Kind of Help is Needed?
Score 21-30
People with this score function independently. There may be no need for services now, but start exploring options. Make sure that legal and financial plans are in place. Consider which level of care family members would be able or willing to give, as needs change.
Some Tips:
Talk as a family with your older relatives about medical, financial and legal arrangements and personal preferences. Encourage them to fill out a health care directive (living will) and to write a will, or to review existing documents.
Help older adults do as much as possible for themselves, and recognize your own limitations. That can help them remain more vigorous and alert and help you avoid caregiver burnout.
Find out about community resources. Keep a file of articles and advertisements for services. Tour senior housing and assisted living apartments in the area.
Complete a home safety evaluation to minimize the risk of falls and to improve safety.
Review this assessment regularly to track changes.
Score 31-50
People with this score may be unable to complete some important daily activities with out help. Consider several options:
Community based services include a broad spectrum of help. Evaluate whether some of them are practical and affordable. Some seniors qualify for economic assistance through a county social service office. For safety, it may be more difficult for people with memory loss to continue to live at home.
As needs increase, costs of services may exceed similar services in residential care homes of assisted living apartments.
Adult day care provides structured activities and meals. Some offer health services and transportation. Most can be attended full or part time.
Companion programs provide in-home visitors who can help with shopping, meals, housekeeping and companionship. They do not provide medical care and usually do not give personal care such as bathing or dressing. Twenty-four hour care can run upwards of $250 per day.
Home health care provides medical care in the house. Services may be provided by a nurse, occupational, speech or physical therapist, 24-hour security and on site staff. Residents may choose to eat in a common dining room.
Residential care/memory loss homes are similar to assisted living, and are designed for people with Alzheimer’s or other memory impairing illnesses.
Score 51-66
People with this score are unable to care for themselves and have health problems. Some may need rehabilitation and may be able to return home.
Nursing homes provide complete personal and medical care for people who are unable to manage independently. That can include short term rehabilitative services as well as long term care for very frail people.
Residential care/memory loss homes are designed for people with Alzheimer’s or other memory loss conditions. They can work well for people who need supervision but do not need intensive medical care.
24 hour home health services are available to very frail people who prefer to remain at home and receive 24-hour care from a home health agency. This will cost much more then nursing home care. Hospice services include medical and social programs for terminally ill people and their families.
This assessment form was developed by Carla MacGregor, a Minneapolis social worker who operated Transitions, Inc., a private geriatric case management firm. She produced it for Care Providers of Minnesota, a nursing home trade association.
This is a tool to begin the care planning process but, it is not to be used in place of a comprehensive assessment from a geriatric specialist, which may take into account additional factors. This is not meant to diagnose or treat.
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