Is it Time to Consider Assisted Living?
Assisted Living Self-Assessment
Let this assessment help you and your family and caregivers reflect honestly on current needs and whether Assisted Living at Meadow Peak might be the right next step.
Please answer each question honestly. For most questions, choose one of the following:
Never / Rarely / Sometimes / Often / Always (or **Yes / No** where noted)
Would you like to speak with someone?
Schedule a confidential tour or phone consultation with our admissions team today.
ASSISTED LIVING CARE FAmILY-Assessment
ALF Assessment
Here’s a compassionate and practical Memory Care Self-Assessment with 35 questions. It’s designed to help families and potential residents evaluate whether memory care might be the right option. You can use this as a web form, downloadable PDF, or guided discussion tool.
Memory Care Self-Assessment
Is it time to consider specialized memory care?
This assessment focuses on cognitive changes, safety risks, and care needs common in Alzheimer’s, dementia, and other memory-related conditions. Answer honestly as a family member or with your loved one.
For most questions, choose:
Never / Rarely / Sometimes / Often / Always
(or Yes / No where noted)
Download our Assessment Questions
Questions
Section 1: Daily Activities & Personal Care
1. Do you need help getting dressed or choosing appropriate clothes?
2. Do you struggle with bathing or showering safely?
3. Do you have difficulty grooming (hair, shaving, nails)?
4. Do you need reminders or assistance with toileting or managing incontinence?
5. Do you have trouble preparing meals or eating independently?
6. Are you able to take your medications correctly without help?
7. Do you need assistance with housekeeping or laundry?
8. Is it becoming harder to move around your home safely (walking, transferring from bed/chair)?
Section 2: Health & Safety
9. Have you had any recent falls or near-falls in the last 6 months?
10. Do you worry about being alone in case of an emergency?
11. Do you feel your current home is no longer safe for you?
12. Have you been hospitalized or visited the ER in the past year due to a fall, medication issue, or forgetfulness?
13. Do you manage your chronic health conditions (diabetes, heart disease, etc.) well on your own?
14. Do you ever forget to eat or drink enough during the day?
15. Are you sleeping well, or do you have frequent sleep disturbances?
Section 3: Memory & Cognition
16. Do you frequently misplace items or forget where you put things?
17. Do you sometimes get lost or confused when driving or walking in familiar places?
18. Do you have trouble remembering appointments, bills, or important dates?
19. Have family members expressed concern about your memory?
20. Do you repeat questions or stories in conversation?
21. Are you still able to manage your finances and pay bills accurately?
Section 4: Social & Emotional Well-Being
22. Do you often feel lonely or isolated at home?
23. Have you stopped participating in hobbies or activities you used to enjoy?
24. Do you find it difficult to get out of the house for social visits or errands?
25. Are you eating regular, nutritious meals?
26. Do you feel anxious or depressed more often than before?
27. Would you enjoy having more opportunities to socialize with peers?
Section 5: Caregiver & Family Support
28. Do you currently have family or friends helping you regularly?
29. Is your family caregiver feeling overwhelmed or burned out?
30. Are you worried about becoming a burden to your loved ones?
31. Has your spouse or partner expressed difficulty keeping up with caregiving demands?
32. Do you live alone, or is there someone available 24/7 if needed?
Section 6: Overall Readiness
33. Are you open to the idea of moving to a community where help is available if you need it?
34. Would you like to maintain your independence while having support nearby?
35. On a scale of 1–10, how concerned are you about your current living situation and safety? (1 = not concerned, 10 = extremely concerned)
Scoring & Next Steps
– If you answered “Often” or “Always” to 8 or more questions** — especially in Daily Activities, Health & Safety, or Memory sections — it may be time to explore assisted living options.
– If safety concerns (questions 9–12) or caregiver burnout (28–31) are present** — even with fewer total “yes” answers — a tour of assisted living communities is strongly recommended.
– Many people benefit from assisted living long before they reach a crisis point.