Adult Caregiving: Information, Advice and Support

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1. Who is an “Adult Caregiver”? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

2. The Growing Impact of Adult Caregiving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

3. Advice for Adult Caregivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

4. Resources and Options Available to Adult Caregivers . . . . . . . . . . . . . . . . . . . . . . . . 8

5. Making Health Care and Financial Decisions According . . . . . . . . . . . . . . . . . . . . .10

to a Client’s Choices – Powers of Attorney

6. Next Steps.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

7. Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

8. Addendum .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

a. Resource Links for Adult Caregiving

b. An Adult Caregiver’s Home Safety Checklist

c. An Adult Caregiver’s Needs Assessment Worksheet

Contents

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Examples of Adult Caregiving include

caring for a spouse who has suffered

from a physically-limiting event or

situation, such as arthritis, a stroke or a

heart attack. It can also entail caring for

a parent or other loved one with a

cognitively limiting condition such

as Alzheimer’s Disease or for a child with

traumatic brain injury from a car accident.

Informal caregiver and family caregiver are

terms that refer to unpaid individuals such

as family members, friends and neighbors

who provide care. These individuals may

live with the person being cared for or live

across the country. Formal caregivers are

volunteers or paid care providers

associated with an organization such as

a home care agency.

What is an “Adult Caregiver”?

No matter which of these caregiving

situations you may be in, you should

understand that you are not alone

— millions of Americans are Adult

Caregivers. If you are feeling

physically or emotionally overwhelmed,

this is a very normal reaction and there

is help available.

The guide that follows is a good starting

point when gathering advice and resources

for Adult Caregiving.

YOU ARE NOT ALONE AS AN ADULT CAREGIVER.

The National Family Caregiver Association estimates that 1 in 4 adults provide care to another adult.

An Adult Caregiver refers to an adult who provides assistance to anyone who is physically or cognitively impaired. This assistance can vary by circumstance and includes anything from helping with bathing and personal hygiene tasks to running errands or grocery shopping. Whether someone actually provides such assistance themselves, or coordinates the services of others who provide the assistance, they are considered an Adult Caregiver.

The Growing Impact of Adult Caregiving

A woman writes: “My husband’s 85-year-old mother lives more than 150 miles away. She is growing frail, and we worry about her a lot. She will not consider moving closer to us, she wants to stay in her house of 60 years, and we don’t blame her…we are really feeling a heavy weight of responsibility. We are at a loss in knowing how to approach this whole issue.”

Her situation communicates the essence of

why Adult Caregiving has become such an

important consideration in today’s society.

The segment of Adult Caregivers that is

growing most rapidly today is comprised

of those who provide care to the elderly.

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THE GROWTH IN ADULT CAREGIVING

The convergence of three demographic trends explains this growth in elderly caregiving:

1. The Baby Boomers are aging, and their parents are living longer.

2. Women – the traditional caregivers – are in the workplace and not available to provide daily care.

3. Our mobile society has left families separated, sometimes by thousands of miles.

Statistically Speaking:

• The strain of providing care for an

elderly loved one is an everyday reality

for an estimated 25 percent of

American families. Again, if you are

an Adult Caregiver, you are not alone.

• 52 million informal and family

caregivers provide care to someone

aged 20+ who is ill or disabled.

• 34 million adults (16% of population)

provide care to adults 50+ years.

• Unpaid family caregivers are estimated

to reach 37 million caregivers by 2050,

an increase of 85% from 2000.

Mental and

Emotional Effects:

• Studies consistently report higher levels

of depressive symptoms (20% to 50%

of Adult Caregivers) and mental health

problems among caregivers than among

their non-caregiving peers. In short, it

is normal to feel overwhelmed by Adult

Caregiving responsibilities.

• Several studies have shown that

caregivers use prescription and

psychotropic drugs more than

non-caregivers.

Economic Effects:

• If the services provided by informal

caregivers (i.e. family, friends, neighbors)

had to be replaced with paid services, it

would cost an estimated $257 billion.

• A recent study found that the

cost to U.S. business due to lost

productivity of working Adult

Caregivers (absenteeism, workday

interruptions, early retirement, etc)

ranges from $17.1 billion to $33.6

billion per year. It’s not just the Adult

Caregiver who is affected by their

caregiving responsibilities, but their

employers, supervisors, co-workers,

and colleagues as well.

• As a result of their caregiving, informal

caregivers are estimated to each lose

an average of $25,494 in Social

Security benefi ts, an average of

$67,202 in pension benefi ts and an

average of $566,433 in wage wealth.

• Long-distance caregivers spend an

average of $392/month on travel and

out-of-pocket expenses as part of their

caregiving duties.

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How Prevalent is the Adult Caregiving Issue?

Advice for Adult Caregivers

Tips to Avoid

Caregiver Burnout

• A few hours per week of ‘down time’

can make a world of difference. See a

counselor or make a point of scheduling

time out of the house with a friend.

• Monitor your health. Stress and

inadequate sleep can take a negative

toll on an Adult Caregiver’s physical

and mental well-being.

• Stay connected to others. Providing

care for someone can lead to a sense

of isolation.

• Attend caregiver support

group meetings.

What are some warning

signs that my loved

one’s caregiving needs

are changing?

• Changing relationships with others/

withdrawal from social interactions.

• Unusual behavior, such as being overly

quiet, loud or agitated.

• Neglecting personal care, including

hygiene and nutrition.

• Signs of forgetfulness such as piles

of newspapers, unopened mail and

scorched pans.

• Mismanaging fi nances, not paying bills

or making unusual purchases.

• Not keeping up with household chores.

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Adult Caregivers should have a plan in place to avoid the pitfalls and burnout that are common to people in this position. Many informal caregivers tend to ignore or put aside their own needs, which can be detrimental to themselves and the individual for whom they are caregiving.

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• Do not be afraid to seek or accept

assistance. There are many free or

economical public and private services

for Adult Caregivers seeking a respite

from providing continuous care.

• Talk with your loved one to fi nd out

what they need and what will accept.

• During your visits, watch for

warning signs of declining abilities,

such as changes in grooming, eating,

or social activities.

• If you notice what appears to be a

decline in thinking and reasoning, you

might want to ask a physician to “test”

your loved one for cognitive function.

• Buy a workbook to organize

information. Keep track of your

loved one’s medical condition and

prescription drug information.

• Establish a network of support (friends,

relatives, neighbors, and physicians),

and keep in touch.

What can Adult

Caregivers do when

warning signs appear?

Avoid Burnout

» Watch for warning signs that your loved one’s needs are changing.

Warning Signs

» Caregivers should attend to their own needs.

React» Plan ahead to take

action when warning signs appear.

Resources and Options Available to Adult Caregivers

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First of all, it’s important to know what

fi nancial resources may be available to pay

for those services that Informal Family

Caregivers usually provide. Medicare,

Medicaid and most employer-sponsored

HMO and PPO plans reimburse only

for intermittent visits from a home care

nurse on a temporary basis, when a

patient has a specifi c qualifying medical

diagnosis. In general, these types of

insurance are not designed to pay for

ongoing, hourly caregiving services that

are classifi ed as “Long-Term Care.” Use

the Offi cial Medicare Eligibility Tool at

www.medicare.gov/LongTermCare/Static/

Medicare.asp to learn more.

However, many other fi nancial vehicles

are available that will pay for ongoing

caregiving services:

• Long-Term Care Insurance

• Worker’s Compensation and

Catastrophic Auto Insurance policies.

• Reverse Mortgage Funds

• Employer Sponsored Health Savings

Accounts or Flexible Spending Accounts.

• Employer-Sponsored caregiving stipends

– such as “Back-Up Care” programs for

employees who are Adult Caregivers and

travel for work

• Family Trust Funds

• State-subsidized Home and

Community Based Services (“Medicaid

Waiver”) programs. Age and income

qualifi cations do apply

Making the choice to provide informal care is a brave and diffi cult decision for many American families, but they don’t have to go it alone. There are ample resources available in many communities to guide and assist these families who undertake the task of providing care to an elderly or disabled loved-one.

If I want to care for my loved one in the home, what are

my options?

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Another option is hiring additional paid

help to supplement caregiving needs. A

paid caregiver can be hired to work in

whatever setting a care recipient may

call home: their own private residence,

a senior retirement community, a group

home, or a rehabilitation facility.

Hiring a private in-home caregiver is one

possibility. A trusted family member,

friend or neighbor may be a cost-effective

option. Bear in mind that you are

assuming employer responsibilities when

hiring privately, and most homeowners

insurance policies exclude injury to

privately-hired caregivers.

Many Adult Caregivers engage the

services of a private duty home care

agency to provide services to a loved-one

when more services are needed than a

privately-hired caregiver can be expected

to provide. Home care agencies should

be willing to provide proof of background

checks, any required licensing, bonded

and insured caregiving staff, formal

training programs for staff, and 24-hour

emergency scheduling services. The

National Private Duty Association is

a good source of home care agency

resources: www.privatedutyhomecare.org.

Finally, adult day care centers provide

daytime respite services for working Adult

Caregivers during weekdays.

Caregiver Tip: Adult day care centers provide daytime respite services for working Adult Caregivers during weekdays.

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Seven Important Questionsto Ask When Hiring Paid Help

1. If the hired caregiver becomes ill or

otherwise unavailable, what alternate

arrangements can be made?

2. Are social security, federal and

state taxes, and unemployment

insurance paid so the family is not

legally responsible?

3. Do we have verifi cation that the paid

caregivers can legally work in the U.S.?

4. If the hired caregiver is injured, who

is responsible? Remember that many

homeowner’s insurance policies

exclude such injuries via “domestic

employee exclusions.”

5. Are criminal history background

checks, state abuse registries

checks and prior work reference

checks completed?

6. Is there bonding and insurance in

place that would cover any injury to

the client or theft?

7. Assuming family is not available to

supervise paid caregivers at all times,

will there be documentation that

substantiates the completion of services?

Answering these questions may be less of a priority if a trusted friend or family member is available. If this option is not available, as is the case for millions of Adult Caregivers, it is important for the family to ask these questions.

Caregiver Tip: If the Adult Caregiver does not have the time and/or resources available to answer these important questions, the services of a professional home care agency or adult day care center — who should take responsibility for the items above as part of their fee — may be the right solution.

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Whether you hire a private caregiver, a

home care agency or an adult day care

center, letting them see what a typical

day in the life of your loved-one is like is

helpful-not only for the caregiver, but for

the recipient of that care. Everyone will

be more comfortable and it will make

adjusting to someone in the house easier.

It’s probably best to put things in writing,

but also take the time to spend the day

and go through the routine. Acquaint the

workers with who to contact in the case

of an emergency, where supplies are

(medical, clothing, cooking, cleaning),

where the appliances are and how to use

them, and keys and alarm systems.

Also, show the home care worker:

• Likes and dislikes of the care recipient

• Dietary needs

• Mobility issues

• Medications: dosage and how to order

• How to deal with individual behavior/

emotional problems

And remember, ask lots of questions of

the caregiver/agency in order to assure

everyone is clear!

Orienting Your Paid Caregivers

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While terms and formats differ somewhat

from one state to another, there are

typically two types of powers of attorney,

one for the management of fi nances, and

one for the management of health care.

Powers of AttorneyMaking Health Care and Financial Decisions in Accordance with a Client’s Choices

Powers of attorney are a good planning tool to create a way for an Adult Caregiver to act on behalf of another during a period of incapacity or, in the management of fi nances, whenever an individual might fi nd it convenient to delegate fi nancial responsibilities.

Caregiver Tip: To learn more about powers of attorney, contact an elder law attorney in your area through the National Academy of Elder Law Attorneys (www.naela.org) to discuss your needs and concerns.

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A Health Care Power

of Attorney

Health care power of attorney becomes

active only when an individual is so ill that

he or she cannot make or communicate

a health care decision to his or her

physicians. For example, if Mr. Jones is in

a coma, or if he develops dementia, which

impairs his understanding and judgment,

the agent nominated by Mr. Jones in his

health care power of attorney has the

authority to make health care decisions for

Mr. Jones.

Do not assume that family members

automatically have the right to make

these types of decisions. Most state laws

are quite vague on who is permitted to

make medical decisions for another; a

valid power of attorney clarifi es the

decision-maker for physicians.

Further, a health care power of attorney

may state an individual’s instructions

regarding life support issues (CPR,

ventilators or respirators and tube or

intravenous feedings and hydration) if he

or she becomes terminally ill. More than

one agent can be named, typically giv-

ing an order in which the agents are to be

contacted. For example, Mr. Jones might

make his son who lives in town his pri-

mary health care agent, but could name

his out-of-state daughter as a second agent

should physicians be unable to locate the

son in an emergency.

A Financial Power

of Attorney

Financial power of attorney allows an

individual to nominate one or more

trusted individuals who can manage

legal or fi nancial matters. The powers

are typically active once the power of

attorney is executed, so the individual

and agent both have access to the

individual’s fi nances. They share

authority to manage the fi nances, but

they do not share ownership of the

assets. Financial powers of attorney may

use simple state-approved “short forms”

or may state in lengthy text the exact

powers being granted; both types have

their purposes.

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Next Steps

1. Arrange a meeting for all involved

family and loved ones to discuss options.

Be sure to include the wishes of the care

recipient. Discussion items may include

matching the appropriate caregiver,

daily routines health, nutritional and

medication requirements as well as house

cleaning and transportation needs. The

Adult Caregiver’s Needs Assessment

Worksheet included with this Show Me

Guide is a helpful tool when determining

these needs.

2. Gather local community resources, via

the Internet or local phone books, such as

home care agencies, transportation

services and community senior centers.

The attached list of resource links is a

good starting point.

3. Check with your employer’s human

resources department and/or employee

assistance program. A recent report from

the Society for Human Resource

Management indicates that about 1 in 4

companies offer basic elder care provisions

to employees, such as referrals to caregivers

or legal services. About 1 in 11 companies

offer more elder care services, including

fi nancial assistance with in-home care and

extended leaves for emergencies. And don’t

forget to check with your spouse/partner’s

employer as well!

4. Reach out for support in a caregiver

support group or online bulletin board or

“buddy” system.

5. If you decide to retain the services of a

home care agency or professional geriatric

care manager, ask them to develop a

customized “plan of care” that outlines

physical needs, cognitive needs, and goals.

Several simple steps will help families make educated decisions when Adult Caregiving needs arise:

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Frequently Asked Questions

Are the caregivers I hire bonded

& insured?

This should be a standard with any

professional home care agency, inclusive

of criminal history background

clearances on each paid caregiver,

general liability insurance and worker’s

compensation insurance.

Will I have a choice of who comes

to my home?

Within reason, the family should always

have a say in choosing the paid caregivers.

Ask about training, screening and

selection systems used to determine the

best match between a paid caregiver and

the recipient of care.

Will the same caregiver come

each day/shift?

Yes. Developing strong rapport and trust

between the family, care recipient and

your paid caregiver is a vital component to

a successful caregiving experience.

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Frequently Asked Questions

If I change my mind, do I have to

keep the service?

You should never be locked into a

long-term pre-paid contract. Professional

caregiving organizations typically collect

refundable security deposits equivalent

to 1-2 weeks of projected service fees,

rather than asking for pre-payment of

services – no different that the security

deposits collected when one moved into

an apartment.

Do I pay the caregiver directly?

If hiring a paid caregiver privately, or

through a registry service, you should

assume that you will be responsible for

standard employer obligations –

including paying the caregiver(s). Services

via professional home care agencies

utilize an employment model, meaning

they should invoice you for services

How can I verify a shift was

completed for a family member?

Written time cards are often utilized,

allowing family or the client to verify

services on a daily or weekly basis. A few

of the more progressive professional home

care agencies combine written time cards

with a newer technology called Telephony.

Telephony is a Web-based time and

attendance solution, which verifi es arrival

and departure times of paid caregivers

via real-time electronic signals that are

activated by toll free calls made by the

caregiver from the client’s home phone.

How is the privacy of my personal

information maintained?

If you are working with a professional

caregiving organization, you should ask for

written assurance that your personal health

care information will never be shared with

anyone in their organization besides those

directly involved in your loved one’s care,

and never sold to any 3rd party or affi liate

under any circumstances.

Caregiver Tip: Telephony is a Web-based time and attendance solution, which verifi es arrival and departure times of paid caregivers via real-time electronic signals that are activated by toll free calls made by the caregiver from the client’s home phone.

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Do I need a physician’s

authorization/prescription?

Unless services are being reimbursed by

Medicare, Medicaid or a private insurer,

there typically is no pre-authorization,

certifi cation, pre-qualifi cation, or

doctor’s prescription required. You start

the services when you want, and you

decide how much or how little home care

service you would like. If reimbursement

from your insurance company is involved,

ask any professional caregiving

organization if they will assist with the

often time-consuming, but necessary,

billing process.

What services are provided?

Virtually all paid caregiving services

provide “companion level” services to

assist with daily living activities such as:

• Preparing meals

• Medication reminders

• Light exercise

• Shopping and errands

• Maintaining household cleanliness

• Companionship and safety supervision

Many services also utilize formally-trained

certifi ed nursing assistants, home health

aides and personal care assistants to

provide “hands-on personal care services”

such as:

• Bathing and hygiene

• Toileting and urinary/bowel

continence care

• Physical transferring from bed to

wheelchair, wheelchair to toilet, etc.

• Feeding

Some services will also provide skilled

nursing services, performed by Registered

Nurses and Licensed Practical Nurses,

such as:

• Wound care and sterile

bandage changes

• Medication administration

• Feeding tube assistance

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Adult Caregiving Resource Links

Caregiving Education

and Resources

Caring News

Information, advice and support for adult

caregiving. Includes articles and resources

to assist family caregivers and health care

professionals who desire information

about home care services.

www.caringnews.com

Direct Care Alliance

A national, practitioner-based coalition

of long-term care consumers, direct-care

workers, and concerned health care

providers who have come together to

pursue a common goal: broad-based

reforms to ensure a stable, valued and

well-trained direct-care workforce that can

meet consumers’ demands for high-quality

paraprofessional health care services.

www.directcarealliance.org

Eldercare Locator

A public service of the U.S. Administration

on Aging. The Eldercare Locator connects

older Americans and their caregivers with

sources of information on senior

care services.

www.eldercare.gov/Eldercare/Public/Home.asp

Family Caregiver Alliance

Committed to caring for caregivers,

resource site.

www.caregiver.org

Hospice Association of America

A national organization representing more

than 2,800 hospices and thousands of

caregivers and volunteers who serve

terminally ill patients and their families.

www.hospice-america.org

National Academy of Elder

Law Attorneys

Provides information, education,

networking and assistance to those who

deal with the many specialized issues

involved with elderly care legal services

and people with special needs.

www.naela.com

National Area Agencies on Aging

The National Association of Area

Agencies on Aging (n4a) is the umbrella

organization for the 655 area agencies on

aging (AAAs) and more than 230 Title

VI Native American aging programs in

the U.S. The fundamental mission is to

provide services which make it possible for

older individuals to remain in their home.

www.n4a.org

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National Association of

Professional Geriatric

Care Managers

A national network of organizations and

individuals dedicated to improving the

health and independence of older persons;

increasing their continuing contributions

to communities, society and future gener-

ations; and building caring communities.

www.caremanager.org

National Clearinghouse on the

Direct Care Workforce

Provides reliable up-to-date information

for people who are working to improve

direct caregiving jobs.

www.directcareclearinghouse.org

National Family

Caregivers Association

Supports, empowers, educates, and

speaks up for the more than 50 million

Americans who care for a chronically ill,

aged or disabled loved one. NFCA

reaches across the boundaries of

different diagnoses, different relationships

and different life stages to address the

common needs and concerns of all

family caregivers.

www.nfcacares.org

National Guardianship

Association

Promoting a nationally recognized

standard of excellence in guardianship.

www.guardianship.org

National Private Duty Association

The National Private Duty Association

(NPDA) is a non-profi t national voice for

organizations that provide private duty

home care services and an advocate for

services which benefi t the consumers for

whom they care: seniors, children, persons

with disabilities, those with chronic health

conditions, and anyone whose quality

of life can be improved by having a care

worker help in their home.

www.privatedutyhomecare.org

ThirdAge

Legal, insurance, fi nancial, and housing

resources for senior care.

www.thirdage.com

Disease-Specifi c Information

Alzheimer’s Association

A national network of chapters, is the

largest national voluntary health

organization committed to fi nding a cure

for Alzheimer’s and helping those affected

by the disease.

www.alz.org

American Association for

Respiratory Care

AARC is the only professional society for

respiratory therapists in hospitals and

with home care companies, managers of

respiratory and cardiopulmonary services,

and educators who provide respiratory

care training.

www.aarc.org

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Adult Caregiving Resource Links

Disease-Specifi c

Information (continued)

American Cancer Society

The American Cancer Society is the

nationwide community-based voluntary

health organization dedicated to

eliminating cancer as a major health

problem by preventing cancer, saving

lives, and diminishing suffering from

cancer, through research, education,

advocacy, and service.

www.cancer.org

American Diabetes Association

The American Diabetes Association is

the nation’s leading non-profi t health

organization providing diabetes research,

information and advocacy.

www.diabetes.org

American Heart Association

The American Heart Association is a

national voluntary health agency whose

mission is to reduce disability and death

from cardiovascular diseases and stroke.

www.americanheart.org

American Lung Association

Founded in 1904 to fi ght tuberculosis, the

American Lung Association® today fi ghts

lung disease in all its forms, with special

emphasis on asthma, tobacco control and

environmental health.

www.lungusa.org

American Stroke Association

The division of the American Heart

Association that’s solely focused on

reducing disability and death from stroke

through research, education, fundraising

and advocacy.

www.strokeassociation.org

National Parkinson Foundation

Educational site on Parkinson’s disease.

www.parkinson.org

Senior Health and

Aging Information

Administration on Aging

Learn more about the Older Americans

Act, the federal legislation establishing the

AoA and authorizing a range of programs

that offer services and opportunities for

older Americans and their caregivers.

www.aoa.gov

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American Society on Aging

Our resources, publications and educational

opportunities are geared to enhance the

knowledge and skills of people working with

older adults and their families.

www.asaging.org

CMS-Centers for Medicare &

Medicaid Services

US Dept of Health and Human Services

Web site – includes resources for Medicare

and Medicaid programs.

www.cms.hhs.gov

FirstGov

Offi cial US Government Web site. Laws,

regulations and legislation related to senior

care issues.

www.seniors.gov

Kaiser Foundation

The Henry J. Kaiser Family Foundation is

a non-profi t, private operating foundation

focusing on the major health care issues

facing the nation.

www.kff.org

Medicare

Offi cial US Government Web site for people

with Medicare.

www.medicare.gov

National Alliance for

Hispanic Health

To improve the health and well being of

Hispanics. The National Alliance for

Hispanic Health is the premier organization

focusing on Hispanic health.

www.hispanichealth.org

National Council on Aging

National Council on Aging (NCOA)

is dedicated to improving the health

and independence of older persons

and increasing their continuing

contributions to communities, society,

and future generations.

www.ncoa.org

National Organization on Disability

The mission of the National Organization

on Disability (N.O.D.) is to expand the

participation and contribution of America’s

54 million men, women and children with

disabilities in all aspects of life. By raising

disability awareness through programs and

information, together we can work toward

closing the participation gaps.

www.nod.org

National Policy & Resource Center

on Nutrition & Aging

National Resource Center on nutrition,

physical activity and aging.

nutritionandaging.fi u.edu

The Center for Social Gerontology

A non-profi t research, training and social

policy organization dedicated to promoting

the individual autonomy of older persons

and advancing their well-being in society.

www.tcsg.org

United We Ride

Coordinates transportation resources for

seniors and the disabled.

www.unitedweride.gov

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An Adult Caregiver’s Home Safety Checklist

All Rooms:

No loose carpeting or rugs that do not have a non-slip backing.

Traffi c areas free of furniture.

Electrical cords and other wires taped against walls.

Bright lighting with switches and all light bulbs in working order.

Telephones placed on tables at a height that can be reached from the fl oor.

Stairs and Inclines:

Free of items placed on the steps.

Plenty of room to move at top and bottom of stairs.

No loose carpeting or edges to catch on.

Handrails securely attached and at the proper height for user.

Proper lighting on all steps, including switches at top and bottom of stairs.

Bathroom:

Grab bars near the tub, shower and toilet located and mounted properly.

Non-slip surfaces in the tub or shower.

Nightlight for when fi rst entering the room.

Rugs or bathmats with non-slip backing on the fl oor.

Shower/tub bench or seat.

23

Bedroom:

Bedside table with non-tip lamp and room for eyeglasses.

Clear traffi c area from bedroom to bathroom.

Comfortable, sturdy chair to aid in dressing.

Kitchen:

Items placed where they can be reached without the use of a stool.

Area to sit during food preparation.

Flooring free of cracks, splits or up-turned edges.

Individual:

Someone checking on the individual daily.

Schedule vision check.

Discuss medications with physician to determine affects on balance.

Establish light exercise routine.

24

Activities Of Daily Living (ADLs)

Activity Accomplishes alone Needs some help Needs much help

Bathing

Dressing

Grooming

Toileting

Eating a nutritious diet

Getting out of bed

Getting out of chair

Walking

Instrumental Activities Of Daily Living (IADLs)

Activity Accomplishes alone Needs some help Needs much help

Using the telephone

Shopping for personal items

Transportation

Managing money

Doing laundry

Doing light housework

Preparing meals

An Adult Caregiver’s Needs Assessment Worksheet This worksheet will help

you and other family members determine what types of assistance your loved one needs.

25

Conditions/Functional Status

How do the following affect the person’s ability to function?

Limitation No effect Some effect Major effect

Hearing

Vision

Perception

Orientation

Thinking

Memory

Decision-Making/Judgment

Physical dexterity

Balance

Strength

Energy

Bladder or bowel control

Arthritis

Hypertension

Heart disease

Diabetes

Physical deformity

Depression

Environmental Safety

Which barriers can be removed or changed?

Neighborhood: Limitation No Problem Needs to be changed

Safety

Convenience

Friends or relatives nearby

Living Quarters:

Condition

Age of dwelling

Roof in good repair

Windows in good repair

Siding in good condition

Looks cared for

Security and safety

Dead bolt locks on outside doors

Peephole in front door

Window bars or locks

Visible from road (no large trees or bushes block view)

Smoke alarms installed, tested

Passageways clear of wires and clutter

Stairs:

Free of obstacles and clutter

Well-lit

Handrails on both sides

In good repair and nonskid

Clearly marked

26

An Adult Caregiver’s Needs Assessment Worksheet

27

Floors: Limitation No Problem Needs to be changed

Nonskid level surfaces

Nonglare surfaces

No loose rugs

Furnishings:

Couch and chairs easy to use

Tables the right height

Bed easy to get in and out of

Lighting:

Light switches easy to reach

Entries and walkways well-lit

Reading areas well-lit

Light diffused from windows and surfaces (no glare)

Passageways have night lights

Kitchen:

Lever handles on sink

Clean rubber mat by the sink

Items used often are accessible

Storage is easy to get to

No objects are over the stove

Well-lit

Bathroom:

Grab bars attached to studs, by the toilet and tub or shower

Nonskid strips in the tub or shower

Hand-held shower head

Nonslip bath mat or rug

Reproduced with permission from FamilyCare America, Inc

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