Welcome to your Senior Living Options Decision Quiz

The following quiz will help you determine the level of care needed for you or your loved one. You will see your results when you complete the quiz.

1. Transportation and Appointments:

Independently drives and maintains vehicle.

Independently schedules and keeps all appointments.

Needs to have appointments scheduled for him or her.

Needs transportation to appointments, shopping due to physical restrictions.

Needs transportation to appointments, shopping due to confusion.

2. Medications:

Able to take all medications as ordered or recommended and can maintain an adequate inventory of medications.

Needs reminders to take medications.

Needs physical assistance in opening medication packaging and pouring correct doses.

Needs assistance with eye drops, ear drops, nebulizers, ointments, inhalers and/or medication patches.

Needs complete assistance with all medications.

3. Ambulation:

Moves independently .

Moves independently with a cane or walker.

Moves with occasional assistance.

Moves with assistance due to physical limitations and/or confusion.

Has experienced recent falls.

4. Dressing and Undressing:

Independently dresses him or herself. Able to choose clothing appropriately for changing weather and temperature needs. Changes clothing regularly.

Needs reminders to change clothing and/or select clothing appropriately.

Needs assistance with dressing and/or undressing.

Resists changing clothes or dressing/undressing.

Needs complete assistance with dressing and/or undressing.

5. General Hygiene and Grooming:

Cares for self in all areas of daily living including bathing and grooming.

Needs some reminders for bathing and grooming.

Needs supervision for bathing and/or grooming, but can perform these tasks.

Needs physical assistance with bathing and/or grooming.

Needs complete assistance.

6. Personal Hygiene:

Requires no assistance managing personal hygiene needs.

Incontinent but able to maintain hygiene with proper use of supplies.

Needs occasional assistance with problems related to incontinence.

Unable to manage incontinence and needs assistance with bathroom use.

Needs complete assistance.

7. Mental Status:

Completely aware of surroundings, recognizes and remembers people, knows dates and times without reminders.

Has difficulty remembering names, the date and time of day.

Has trouble remembering things that happened recently.

Unable to recall names, dates and/or time of day and has difficulty making decisions. Problem solving skills are impaired.

Does not recognize familiar people, unable to recognize date, time and/or surroundings. May have lost language skills.

8. Behavior:

Handles emotions without difficulty, copes with stress and gets along well with others.

Isolates oneself from the company of others.

Requires occasional intervention to manage periods of frustration, anxiety and/or agitation.

Needs intervention on a regular basis to avoid outbursts.

Has demonstrated abusive, uncooperative or harmful behavior.

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Welcome to your Senior Living Options Decision Quiz

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