05/24/2016
SIGNS YOUR LOVED ON MAY NEED IN HOME CARE
The following checklist will help you identify your care needs. With this information, your health care provider can help you customize a care solution. Review the following checklist and write "yes" next to any items that you have recently observed.
Does your loved one…
1.(Mental Aspects)
Feel forgetful, confused or lost?
Mix up or forget to take medications?
Miss doctors' appointments?
Overlook things that pose a safety concern?
Struggle to pay bills or buy food?
Receive a lot of junk mail?
Make payments to unfamiliar people or companies?
Act secretive while on the phone?
2.(Emotional and Social Aspects)
Feel lonely or depressed?
Feel frustrated or stressed?
Take less interest in things previously enjoyed?
Avoid people and social interaction?
3.(Physical and Medical Aspects)
Sleep more often or have less energy?
Notice a change in eating habits?
Have difficulty walking, dressing, eating or bathing?
Have trouble cleaning or maintaining a household?
Fall more often or bruise more easily?
Need medical attention or additional personal care?
Take medication that you think needs to be adjusted?
Need daily/weekly treatments, such as dialysis or IV therapy?
Use medical equipment, such as an oxygen tank?
Count the number of questions you answered "yes" too...
5-7: Potential need for in home care indicated.
7-15: Strong need for in home care indicated.
15 or higher: Considerable need for in home care indicated.
