Care Need Assessment

Reagan Callaghan, RN, BSN, CCM, GCM
Managing Director/Owner
Elder Advocates of SC, Inc.
phone:843-488-0767

Care Need Assessment There are numerous warning signs and behavioral changes that may indicate you or a family member would benefit from our services. We invite you to answer a few simple questions. Based upon the results, we will be in contact with you with additional assistance.
Contact Information
Your name [Required]
Your email [Required]
Your phone number [Optional]
Assessment Questions
Do you have a parent, aging relative or close friend living in the Grand Strand area? [yes=1]	Yes No
Is this senior living alone? [yes=2]	Yes No
Is this senior caring for another senior or are they being cared for by a senior? [yes=2]	Yes No
Does this senior have multiple medical problems or a chronic debilitating illness? [yes=2]	Yes No
Do you know this senior's physicians? [no=1]	Yes No
Does this senior take multiple medications? [yes=1]	Yes No
Is this senior able to safely get to doctor's appointments, grocery stores and run errands? [no=1]	Yes No
Does this senior rely on aging friends and neighbors for assistance in the home, with transportation, or financial/legal matters? [yes=2]	Yes No
Is this senior able to manage their own finances? [no=1]	Yes No
Are you aware of any personal needs this senior has (bathing, dressing, nutritional)? [yes=1]	Yes No
Does this senior have difficulty with car or home maintenance? [yes=1]	Yes No
Does this senior have a living will, healthcare power of attorney, or any final/funeral plans? [no=1]	Yes No
A score of 6 or more is a clear indication of a need for intervention on your part in order to insure the safety and well-being of your family member or friend. Of course, any score validates your concern and should be taken into consideration.

Disclaimer: Elder Advocates of SC, Inc. is an independent company and is NOT affiliated with MyElderAdvocate, LLC or any of its franchises.

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