By Jesus Tucker,2014-07-09 19:45
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Assessment ...

    Family Caregiver Assessment

    Use these questions to assess your family member’s current situation and as part of a conversation to identify needs and reinforce what is working


    Physical Health

    ? Has your family member been diagnosed with any chronic diseases,

    such as diabetes, high blood pressure, arthritis, emphysema?

    ? Has your family member experienced fractures or trauma, unusual

    weight gain or loss, incontinence, balance problems?

    ? Does he/ she have dental problems?

    ? Do you have a list of the health professionals he/she is currently



    ? Has your family member been diagnosed with any psychiatric

    disorders, such as depression, anxiety disorder, psychosis?

    ? Has he/she been diagnosed with Alzheimer's disease or other


? Is he/she alert? Does he/she have mood swings?

    ? Does your family member exhibit signs of extreme forgetfulness,

    wandering off, confusion, disorientation, sadness, or loneliness?

    ? Have you noticed a decreased interest in reading, writing,

    communicating, and maintaining friends, or less interest in life in


    Medications The bottom

    line: ? Check all the medicines your family member takes. Talk openly Note times per day and doses. with your

    parents about ? Is your family member able to take medications as

    their living directed, and does he/she know how to avoid

    situation, and interactions?


    assistance ? Does he/she have problems using medicine

    should they properly?

    need it.

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    Area Agency on Aging 2005 Family Caregiver Education

    Daily Living ? How is your family member’s ability to move around the home? Is there

    a need for adaptive aids, such as a cane, walker, or grab bars in the


    ? Does he/she have special dietary needs?

    ? Is he/she able to dress, bathe, get up from a chair easily, use a toilet,

    use the phone, climb stairs, get help in an emergency, shop, prepare

    meals, do housework, drive safely?

    Environmental Safety

    ? How is the neighborhood?

    ? Is their home safe (e.g., Is it free of hazards such as throw rugs)? Does

    it have working smoke alarms and fire extinguishers?

    ? Is he/she able to avoid telephone scams and door-to-door fraud?

    ? Can he/she maintain the house and yard?

    Support System ? Does he/she have the names, addresses, and phone numbers of key

    family members, friends, and neighbors readily available?

    ? Does your family member have frequent visitors or see friends?

    ? Do your parents go to a senior center? Do they go out of the house for

    social reasons?

    ? Does he/she belong to organizations, including faith-based groups?

    ? Do family members live nearby? Do they see these relatives regularly?

    Appearance and Hygiene

    ? How is his/her appearance/personal hygiene? Does he/she routinely

    brush teeth, trim nails, shave, wash and comb hair?

    ? Are his/her clothes clean, and is he/she dressed appropriately?


    ? What insurance does he/she have?

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    Area Agency on Aging 2005 Family Caregiver Education

    ? Do you have a general idea as to your family member’s personal


    ? Are there any legal documents such as trusts, living wills, durable or

    other powers of attorney? Do you know where important records are


    ? Does your family member have a financial plan?

    ? Are there outside sources of financial assistance?

    ? Does your family member pay bills on time and make reasonable

    financial decisions?


    ? Does your family member have hobbies?

    ? What about television/radio programs, reading preferences?

    ? Does he/she exercise regularly?

    ? Does he/she play a musical instrument? Does he/she or speak more

    than one language?

? What are his/her favorite topics of conversation? What are his/her

    Their important life events, spiritual backgrounds, accomplishments,

    social activities?

    Source: AARP,

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    Area Agency on Aging 2005 Family Caregiver Education

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