Home Health Assessment

If you find yourself in the role of caring for a family member dealing with health challenges, rest assured you're not alone. In the United States, over one in three Americans are in similar circumstances. Navigating this responsibility can be daunting, particularly if you're unsure of where to seek guidance and assistance.

This quiz aims to provide you with a customized report, shedding light on the risk factors affecting your loved one and exploring the potential benefits of home health care.

QUIZ | 11 questions | 5-10 min

Have they experienced any of the following in the past 3 months?

Serious illness (pneumonia, infection, flu)

Trouble eating or swallowing

Joint replacement or surgery (knee, hip, shoulder, etc.)

Depression

Falls, dizziness or loss of balance

Amputation

Has your loved one been diagnosed with a terminal condition, with six months or less life expectancy?

Yes

No

Not too sure

Does your loved one have trouble keeping track of which medications they’re supposed to take, or have they accidentally taken the wrong medication or dosage?

How often do they visit or call the doctor to deal with symptoms of their condition or side-effects from medication?

How difficult is it for your loved one to leave home? Please select the option that best describes their current situation.

Their condition makes it very difficult or impossible to even leave bed.

Leaving home requires a lot of effort that exhausts them. They leave home infrequently and briefly because of the difficulty.

They use a walker, wheelchair, or require another person’s help to leave home.

They have some difficulty leaving home, but not enough to stop them from going somewhere.

They have no difficulty leaving home.

Does your loved one have a history of non compliance with medication?

Does your loved one have a Gait Belt or Hoyer Lift?

Gait Belt

Hoyer Lift

None

Has your loved one fallen in the past?

No

Yes and was NOT hospitalized for it

Yes and DID get hospitalized for it

First Name

Last Name

Email *

Phone *

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Serving Connecticut

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