For Families
Care level self-check worksheet
Check what help your loved one needs today. Bring it to tours and to the doctor to talk about the right level of care.
Check each item that applies. This isn't a medical assessment; share it with the doctor or discharge planner.
Daily activities: needs help with
- ☐ Bathing or showering
- ☐ Dressing
- ☐ Using the toilet
- ☐ Getting in and out of bed or a chair
- ☐ Walking (walker, wheelchair)
- ☐ Eating
- ☐ Taking medications on time
Memory and safety
- ☐ Forgets to eat, take medications or turn off the stove
- ☐ Gets lost or confused in familiar places
- ☐ Wanders or leaves home unsafely
- ☐ Recent falls
- ☐ Can't safely be alone at night
Nursing needs
- ☐ Needs daily skilled nursing or therapy (wound care, IV, rehab)
- ☐ Oxygen or other medical equipment
- ☐ Two-person help to move
What the answers often point to
- Mostly daily activities: assisted living may fit.
- Memory and safety items: memory care may fit.
- Daily skilled nursing or therapy: a skilled nursing facility (often short-term rehab) may fit.
Confirm with the doctor or hospital discharge planner.
General information only, not medical, legal or financial advice. Programs and amounts change; confirm with the official source or a qualified professional.