Is Home Health Care the Solution?

More than one in three Americans is caring for a family member with health care challenges.  The experience is often overwhelming for the entire family – especially if you don’t have access to answers and support.

Your responses to the questions below will help us understand the risk factors for your loved one and whether home health care may be able to help.

QUESTION 1

Heart failure or other heart condition Stroke Diabetes COPD or other respiratory condition Alzheimer’s/Dementia/Confusion Cancer Other

QUESTION 2

Serious illness (pneumonia, infection, flu) Joint replacement or surgery (knee, hip, shoulder, etc.) Falls, dizziness or loss of balance Trouble eating or swallowing Depression Amputation

QUESTION 3

Yes No

QUESTION 4

Coumadin/Warfarin (anti-clotting/blood thinner) Insulin or oral diabetic medication Pain Medication IV Medication Dialysis Oxygen Other

QUESTION 5

Frequently – Several times a month Regularly – At least once a month Sometimes – A few times a year Rarely – Once a year or less Don’t know

QUESTION 6

Bathing Getting dressed Preparing food Using the restroom Grocery Shopping Driving

QUESTION 7

Frequently – Several times a month Regularly – At least once a month Sometimes – A few times a year Rarely – Once a year or less Don’t know

QUESTION 8

They’re at high risk of severe illness from COVID-19 (age 65+ or any age with an underlying condition). Their condition makes it difficult or impossible to even leave bed. Leaving home exhausts them. They leave home infrequently and briefly because of the difficulty. They use a walker, wheelchair, or need someone’s help to leave home. They have some difficulty leaving home, but not enough to stop them from going somewhere. They have no difficulty leaving home.