You depend on others to assist you with one or several of these three areas. Long-Term Care

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1 ASSESSMENT GUIDE Is assisted living the right choice for you? Our easy-to-follow Assessment Guide is designed to provide you with a starting point as you determine whether or not assisted living or long-term care is appropriate for you. For each question, select either,, or. BATHING, GROOMING, DRESSING COMMUNICATION You are unable to use a telephone on your own. You are unable to use a telephone on your own.

2 FINANCES MEDICATIONS MENTAL STATUS You require strong orientation, assistance and reminders. Your memory is growing severely impaired.

3 You require strong orientation, assistance and reminders. Your memory is growing severely impaired. You require strong orientation, assistance and reminders. Your memory is growing severely impaired. MOBILITY evacuate yourself in the event of an Use cane, walker, or wheelchair. evacuate yourself in the event of an Use cane, walker, or wheelchair. evacuate yourself in the event of an Use cane, walker, or wheelchair. NUTRITION You can prepare snacks, small meals, and need assistance with main meals. You sometimes have

4 You can prepare snacks, small meals, and need assistance with main meals. You sometimes have You can prepare snacks, small meals, and need assistance with main meals. You sometimes have PHYSICIAN CONTACT SAFETY You require continual contact with another person, it is unsafe for you to be alone for more than 24 You require continual contact with another person, it is unsafe for you to be alone for more than 24

5 You require continual contact with another person, it is unsafe for you to be alone for more than 24 TOILETING

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