Is it time? A checklist to print or keep

This is a way to put what you have noticed in one place, so you can talk it over. It does not add anything up and it does not tell you what to do.

If anyone is in immediate danger, call 911 now. Do not wait to finish this list.

Your ticks stay in this browser. Nothing you tick is sent anywhere, and we do not see it.

Daily living

Tick what has been happening lately.

Meals are skipped, or the same food is eaten every day
Bills or mail are piling up
Housework or laundry is getting left undone
Medicines are missed or taken twice
Getting to appointments is hard
Showering, dressing or grooming has become difficult
The home needs repairs that are not getting done
Days go by without seeing anyone

Safety

Tick what has been happening lately.

A fall, or a near fall
Getting lost, or forgetting where things are
Stove or appliances left on
Stairs or the bathroom are hard to manage
Trouble driving, or a recent accident
Feeling unsafe at home, or worried about being alone

Caregiver strain

For the family member or friend helping. Tick what is true for you.

I am worn out most days
My own health or sleep is suffering
My work or other family is being affected
I feel I am the only one helping
I worry all the time, even when I am not there
I am not sure how much longer I can keep this up

Anything else you want to remember or ask

What to do with this

Ticking more boxes does not mean it is time to move, and ticking few does not mean it is not. Bring this to the people involved, and to the older adult's own doctor if a health concern comes up.

Stay or move: a way to think it through, a longer guide to use together.
Search for places when you want to look at options.
Ask Mary what the different kinds of housing and care mean.
More for family caregivers.

Hi, I'm Mary