Assessment Checklist

If you’re doing an assessment on your own, use this list as a guide provided by the AARP. Explore as many of these areas as you can to get a full picture of your loved one’s life.

Physical health

  • Make note of these factors; you may need the help of your loved one’s doctor.

  • Diagnosis of any chronic diseases such as diabetes, high blood pressure, arthritis, emphysema, or stroke.

  • Unusual weight loss or gain in a short amount of time.

  • Incontinence.

  • Balance problems: How steady is the person while walking?

  • Persistent fatigue or sleeplessness.

  • Swollen feet or legs, or limping.

  • Vision problems such as cataracts or use of vision aids.

  • Hearing problems: Is there a need for a hearing aid? If there is one, is it being worn? 

  • Dental problems including gum disease, halitosis and ill-fitting dentures. 

  • Complaints of pain.

  • List of health professionals being seen. 

 

Mental health

  • Make note of these factors; a primary care doctor can help, but a geriatric psychiatrist or neurologist might be more helpful.

  • Diagnosis of any psychiatric disorders such as depression, anxiety disorder or psychosis.

  • Diagnosis of Alzheimer’s or other form of dementia

  • Recent hospitalizations for any of these problems.

  • Mood swings, including rage or hostility.

  • Forgetfulness or wandering off.

  • Sadness or loneliness.

  • Decreased interest in reading, writing and communicating.

  • Difficulty in maintaining friends.

  • Decreased interest in life.

 

Medication use

  • List all medicines taken, prescription or over-the-counter, with frequency and dosage.

  • List all herbal remedies, supplements, traditional home remedies or vitamins being used.

  • Is the person able to take medications as directed and avoid interactions?

  • Are there any barriers to proper medicine use, such as forgetfulness, expense, poor understanding of purpose and results of use?

 

Daily living

  • List special dietary needs and favorite foods.

  • Describe ability to dress, bathe, get up from a chair, use the toilet, use the phone, climb stairs, get help in an emergency, shop, prepare meals, do housework and yard work, and drive safely.

 

Home and community safety

  • Consider neighborhood safety. 

  • Consider home safety: Are there throw rugs? A need for handrails in the bathroom? Does the residence have working smoke alarms?

  • Is the person able to avoid telephone and door-to-door fraud?

  • What level of maintenance do the yard and house require?

 

Support system 

  • Know contact information for key family members, friends, neighbors and clergy.

  • Does the person have visitors or is he or she able to visit friends and family?

  • Does the person visit a senior center for activities?

  • List membership in organizations and groups.

 

Appearance and hygiene
Factors to assess:

  • Personal hygiene.

  • Overall appearance.

  • Oral care.Trimmed nails.

  • Well showered and shaven.

  • Combed hair.

  • Clean clothes.

  • Appropriately dressed for weather and occasion.

 

Finances
Factors to assess:

  • Insurance coverage.

  • Long-term care coverage.

  • Total assets.

  • Legal documents including trusts, living wills and durable powers of attorney.

  • Is there an attorney who knows this person?    

 

Interests/lifestyles

  • Hobbies.

  • Reading preferences: Are glasses or larger-print books needed? Would books on tape be enjoyable?

  • Favorite TV and radio programs.

  • Exercise — gardening and walking count!

  • Musical instruments played.

  • Languages spoken, and is there a preferred language?

  • Favorite conversation topics.

  • Travel experience.

  • Important life events.

  • Religious/spiritual background.

  • Accomplishments.

  • Social activities.

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