Full Name
Email
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Phone
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Who are you searching for?
Spouse
Parent
Myself
Someone Else
How quickly do you need care?
As soon as possible
Within 30 days
In the next few months
Not in a rush
Do you anticipate needing help with the home and "all the stuff"? (this helps tailor our recommendations)
Yes
No
Let's Look at Options
Bathing/dressing/grooming
Completely independent
Needs set-up or occasional cueing
Needs regular hands-on help
Medications
Self-manages reliably
Uses reminders/family sets up meds
Misses doses or mismanages without help
Meals/nutrition
Shops/cooks consistently
Relies on simple prep/take-out; weight loss or skipped meals
Not eating regularly without oversight
Housekeeping/laundry
Keeps up independently
Some decline/clutter; needs periodic help (1)
Can’t keep up; hygiene or sanitation concerns
Mobility/falls (past 6 months)
Steady; no falls/near-falls
1 near-fall or balance concerns
Falls/ER visit or clear unsteadiness
Driving safety
Safe driver, no concerns
Family uneasy or minor incidents
Getting lost/tickets/accidents; unsafe
Memory
Typical aging lapses only
Forgetting bills/appts; needs frequent reminders
Safety-critical errors (stove, getting lost, meds)
Mood/behavior
Stable
Intermittent anxiety/irritability
Significant mood swings, suspicion, evening agitation
Orientation/wandering
Fully oriented
Occasional disorientation in unfamiliar places
Disoriented in familiar areas or wandering/exit-seeking
Medical complexity
Few, well-controlled conditions
Multiple chronic illnesses needing coordination
Complex/unstable conditions or frequent hospital use
Social engagement
Active; attends events
Some withdrawal; needs prompting
Isolated; rarely leaves home
Continence
Continent
Occasional issues; uses products
Regular incontinence requiring care