Checklists - Assessing Needs

 

As a family member ages, we often don't notice the subtle changes in functioning. When a crisis situation occurs, we then must think back to past behaviors and functioning to determine how the situation became so critical.

For a caregiver, checklists can help you to think about your family member in a practical and functional way. If you decide to work with an Information and Referral Specialist or Caregiver Specialist, having completed the checklists beforehand will help you to help the professional. If you decide to access services yourself, completing checklists can help you to determine what services may be needed and the level of care that will best suit the needs of your family. If you are concerned that your family member may have dementia or Alzheimer's, there is a separate checklist to guide you.

 

 

Ask yourself these questions about your family member.
Be honest.

Do you have concern about your family member in these generalized areas?	Yes	No
Driving
Vision
Hearing
Socializing
Memory
Decision Making/Judgment
Balance
Strength
Energy
Health
Overall Ability to Function Independently

 

From your observations, generally evaluate how your family member performs in these areas:
Activity	Can Do Independently	Needs Some Help	Needs a Lot of Help
Walking
Rising from a seated position
Getting out of bed
Getting in or out of a car
Preparing a meal
Eating a meal
Toileting
Bathing
Getting dressed
Personal hygiene
Doing laundry
Using the telephone
Taking medications
Paying bills
Keeping track of finances
Driving
Shopping
Home maintenance
Household cleaning
Problem solving

 

Check whether your family member has the following medical conditions:
Medical Condition	Yes	No
Alzheimer's Disease
Dementia
Depression
Diabetes
Stroke
Heart Disease
High Blood Pressure
Arthritis
Bladder or Bowel Condition
Cancer
Mental Illness
Parkinson's Disease
Osteoporosis
Emphysema
Dental Disease
Hearing Loss
Vision Loss
Other:
Other:

 

Mobility

Which of the following describes the condition of your family member?	Yes	No
walks independently
occasionally needs assistance
uses a cane
uses a walker
uses a wheelchair

 

Transportation

Which of the following describes the condition of your family member?	Yes	No
has a car and can drive it
has a car and cannot drive it
has a car and shouldn't drive it
doesn't have a car
has transportation through friends
has public transportation available
uses private for-pay transportation
needs transportation

 

Cognitive

Which of the following describes the condition of your family member?	Yes	No
has no noticeable memory problems
occasionally is forgetful
frequently forgets information about friends, family, news events, etc.
frequently forgets things such as locking the door, turning off the stove, medication, etc.
gets confused
gets lost
wanders during the night

 

Social and Emotional

Which of the following describes the condition of your family member?	Yes	No
has lots of friends and sees them regularly
has lots of friends but doesn't see them regularly
doesn't have many friends
is involved in activities outside the home
seems lonely
seems depressed
seems impatient
seems angry
seems stressed

 

Falls

Which of the following describes the condition of your family member?	Yes	No
has had a recent fall
has had a fall that caused an injury
seems unsteady
should be using a cane or walker but doesn't
has many throw rugs in the home
has hardwood floors in the home

 

 

Now that you have answered the questions, take a good look at your answers. If you see a lot of areas where your family member needs assistance, you may want to talk to a professional to help you make wise choices. There is no magic number of problems that should prompt you to get assistance. Each family is different and each person has a different level of tolerance. But use these checklists to help you to see if there seem to be multiple problems and to alert you to whether or not functioning seems to be declining instead of remaining stable. If things are becoming harder to handle and/or if your family member is getting worse, check out your options either with a professional or through resources identified within this website.

Caregiver Specialists are there to help. They have been hired by the local Councils or Departments on Aging. Area Agencies on Aging have Caregiver Specialists as well. Call and discuss the results of your evaluation with them. If even that seems like to much to handle, they can assist you with getting help for your emotional and mental health needs as well. They will help you help both your family member and yourself. Remember to be completely honest with them. Don't be embarrassed to share with them how you are feeling and coping with your situation and any specific problems you may be having. Anything you share will be held in confidence and they will not judge you or the situation you find yourself in. They want to help you which is why they have chosen this career.

 

Caregiver Specialists are Available to Help You

 

 

 

You may also want to consider the following questions:

Caregiver Needs

My Needs	Yes	No
I feel capable of handling this situation myself.
I have family that can help me.
I have friends that can help me.
I have a faith community that can support and help me.
I am willing to ask others for help.
I am feeling the stress of this situation already.
I need someone to help me.

 

What do your answers tell you? This should help you to decide what to do next. Take the answers provided in these checklists and have them handy as you explore other areas of this website. Use the answers to find services and assistance to help you help your family member and yourself.

 

The American Medical Association has developed on online checklist for caregivers to help assess the need for the caregiver to seek support. This may also be useful in deciding if you, the caregiver, need help.

 

 

 

Personalized Assistance

Personalized assistance is available in every state through the Older American's Act and the Family Caregivers Support Program. States may vary slightly in the way assistance is offered so it is best to check with the Area Agency on Aging serving the county in which the person needing assistance lives. Ask for contact information for a Caregiver Specialist or an Information and Referral Specialist. You can also check with any local Senior Center in the area. They should know what is available locally. And, there is always the State Aging Agency which will have statewide information available.

 

 

 

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