Part I: Who needs care?

Who Needs Care at Home?
  • Myself
  • Spouse
  • Parent
  • Grandparent
  • Other Relative
  • Friend
  • Other
  • No elements found. Consider changing the search query.
  • List is empty.
How Old is the Person Who Needs Care?
  • 45-54
  • 55-64
  • 65-74
  • 75-84
  • 85 or older
  • No elements found. Consider changing the search query.
  • List is empty.
Male or Female?
  • Male
  • Female
  • No elements found. Consider changing the search query.
  • List is empty.
What is their current living situation?
  • Living Alone at Home
  • Living at Home with Family
  • In the Hospital Needs a Sitter
  • In the Hospital Discharging to Home
  • Assisted Living
  • Independent Senior Living
  • Nursing Home
  • No elements found. Consider changing the search query.
  • List is empty.

Part II: Type of Care

Estimate How Much Care They Might Need
  • A few hours per week
  • More than 20 hours per week
  • 40 or more hours per week
  • Around-the-Clock Care
  • Live-In Care
  • No elements found. Consider changing the search query.
  • List is empty.
What Type of Care is Needed? (Check all that apply)
  • Bathing/Showering and grooming assistance
  • Toileting and incontinence care
  • Medication reminders
  • Light meal preparation
  • Errands/Shopping/Pharmacy
  • Light housekeeping
  • Light laundry
  • Companionship
  • Escort on appointments (doctor’s office, hair salon, etc)
  • Safety Supervision
  • Hospice Care
  • Respite Care
  • Alzheimer’s and dementia care
  • Other
  • No elements found. Consider changing the search query.
  • List is empty.
How will care be paid for?
  • Private Funds
  • Long-Term Care Insurance
  • Other
  • No elements found. Consider changing the search query.
  • List is empty.

Part III: Personal Information

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