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Assessment Checklist

Article Highlights

  • Your loved one's doctor can help you assess
  • Consider your loved one's dietary needs
  • Take note of appearance and hygiene

If you’re doing an assessment on your own, use this list as a guide. Gently explore as many of these areas as you can to get a full picture of your loved one’s life.

See also: How to assess your loved ones situation.

Physical health

  • Make note of these factors; you may need the help of your loved one’s doctor.
  • Diagnosis of any chronic diseases such as diabetes, high blood pressure, arthritis, emphysema, or stroke.
  • Unusual weight loss or gain in a short amount of time.
  • Incontinence.
  • Balance problems: How steady is the person while walking?
  • Persistent fatigue or sleeplessness.
  • Swollen feet or legs, or limping.
  • Vision problems such as cataracts or use of vision aids.
  • Hearing problems: Is there a need for a hearing aid? If there is one, is it being worn? 
  • Dental problems including gum disease, halitosis and ill-fitting dentures. 
  • Complaints of pain.
  • List of health professionals being seen. 

Mental health

  • Make note of these factors; a primary care doctor can help, but a geriatric psychiatrist or neurologist might be more helpful.
  • Diagnosis of any psychiatric disorders such as depression, anxiety disorder or psychosis.
  • Diagnosis of Alzheimer’s or other form of dementia. 
  • Recent hospitalizations for any of these problems.
  • Mood swings, including rage or hostility.
  • Forgetfulness or wandering off.
  • Sadness or loneliness.
  • Decreased interest in reading, writing and communicating.
  • Difficulty in maintaining friends.
  • Decreased interest in life.

Medication use

  • List all medicines taken, prescription or over-the-counter, with frequency and dosage.
  • List all herbal remedies, supplements, traditional home remedies or vitamins being used.
  • Is the person able to take medications as directed and avoid interactions?
  • Are there any barriers to proper medicine use, such as forgetfulness, expense, poor understanding of purpose and results of use?

Daily living

  • List special dietary needs and favorite foods.
  • Describe ability to dress, bathe, get up from a chair, use the toilet, use the phone, climb stairs, get help in an emergency, shop, prepare meals, do housework and yard work, and drive safely.

Next: Assessing the safety situation»

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