Welcome to our Care Assesment

This personalized tool was created to identify the ideal level of senior care needed for you or your loved one.

Our care assessment was created to provide you valuable knowledge and comfort in this process for you and your loved ones.

It takes around 3-5 minutes to ensure your loved one gets the right care.

What is your loved ones current living situation? *

Living independently at home

Living with family

Living in an assisted living community

Other

How would you describe their overall health? *

Excellent, no major issues

Good, a few minor concerns

Fair, some chronic conditions

Poor, requires daily care and attention

Are there any memory concerns, such as forgetfulness or confusion? *

No memory issues

Mild forgetfulness but can still function independently

Moderate memory issues, occasional confusion

Severe memory loss (Alzheimer’s, dementia)

How independent is your loved one when it comes to making meals and eating them? *

Able to prepare their own meals

Needs meals prepared

Needs meals prepared with reminders

Needs meals prepared with physical assistance

Are there any mobility challenges? *

Fully mobile without assistance

Uses a cane, walker, or other aids

Needs assistance with standing or walking

Primarily wheelchair-bound or bedridden

How often does your loved one need medical attention (medications, doctor visits, etc.)? *

Rarely, only routine check-ups

Occasionally, a few times a month

Frequently, weekly care and medication management

Daily or more frequent medical attention needed

Are there any special dietary needs or restrictions? *

No dietary restrictions

Some restrictions (e.g., low-sodium, diabetic)

Special diet prescribed by a doctor

Tube feeding or other advanced dietary needs

How is your loved one's social engagement? *

Very active, enjoys regular social activities

Somewhat active, participates occasionally

Rarely social, prefers isolation

Avoids all social interactions

What is your primary concern in finding care for your loved one? *

What level of assistance do you think your loved one needs to improve their quality of life? *

Minimal assistance, just a little help

Moderate assistance with daily tasks

High level of assistance, including medical and memory care

Full care with 24/7 support

Full Name *

Email *

Phone *

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