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Comfort Keepers®: The #1 Senior Care Franchise Network from 2012-2020

Survey: Do You Need Home Care?

It may be time for you to consider in-home care for your loved one! Start by taking our short Care Survey to help you better understand whether the time may have come to pursue care options for your loved one. Just answer “Yes” or “No” for each of the questions below. Then, call for an in-home assessment. We’ll determine how to help and then will schedule an in-home assessment at your convenience.

Check “Yes” or “No” for the questions below: *

Signs to Look for in Your Senior Loved One

YesNo
Is your loved one wearing clothing that is dirty or has food stains?
Does your loved one wear his/her night clothes during the day?
Does your loved one wear the same outfit day after day?
Is it apparent your loved one is not showering or bathing?
Does your loved one fail to comb/style their hair or brush their teeth?
Is your loved one losing weight?
Is there unusual tearing or bruising of the skin that may indicate a fall?
Does your loved one fail to recognize you or know your name?
Does your loved one fail to speak normally or have trouble communicating?
Are there signs of confusion such as not knowing the date, where he/she is, or, the season of the year?
Has your loved one withdrawn socially or is he/she less communicative?
Are there foul smells coming from the refrigerator and cupboards?
Are the cupboards void of nutritious food?
Is the home cluttered and does it have newspapers and mail accumulated?
Are you finding expired medications or medications that are not being taken?
Has your loved one fallen recently?
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