Assessment Checklist

Home and community safety

• Consider neighborhood safety. 
• Consider home safety: Are there throw rugs? A need for handrails in the bathroom? Does the residence have working smoke alarms?
• Is the person able to avoid telephone and door-to-door fraud?
• What level of maintenance do the yard and house require?

Support system

• Know contact information for key family members, friends, neighbors and clergy.
• Does the person have visitors or is he or she able to visit friends and family?
• Is he able to visit a senior center?
• List membership in organizations and groups.

Appearance and hygiene
Factors to assess:

• Personal hygiene.
• Overall appearance.
• Oral care.Trimmed nails.
• Well showered and shaven.
• Combed hair.
• Clean clothes.
• Appropriately dressed for weather and occasion.
  

Finances
Factors to assess:

• Insurance coverage.
• Long-term care coverage.
• Total assets.
• Legal documents including trusts, living wills and durable powers of attorney.
• Is there an attorney who knows this person?   
  

Interests/lifestyles

• Hobbies.
• Reading preferences: Are glasses or larger-print books needed? Would books on tape be enjoyable?
• Favorite TV and radio programs.
• Exercise — gardening and walking count!
• Musical instruments played.
• Languages spoken, and is there a preferred language?
• Favorite conversation topics.
• Travel experience.
• Important life events.
• Religious/spiritual background.
• Accomplishments.
• Social activities.