Care Assessment - Manor on 1st

What best describes your current situation?(Required)

I'm exploring options for my parent

I'm a healthcare professional making a referral

I'm exploring options for myself

Other family member or caregiver

What type of care is needed?(Required)

Minimal - mostly independent

Light assistance - occasional help with bathing, dressing

Moderate assistance - regular help with most ADLs

Significant assistance - comprehensive daily support needed

Are there any mobility concerns or wandering risks?(Required)

No mobility issues, not a wandering risk

Uses cane or walker, no wandering concerns

Wheelchair user, not a wandering risk

Has wandering tendencies or significant safety concerns

How would you describe medication management needs?(Required)

Manages independently

Needs occasional reminders

Requires daily supervision and administration

Complex medication coordination needed

Are there any memory or cognitive concerns?(Required)

No memory concerns

Mild forgetfulness

Moderate memory issues affecting daily life

Significant cognitive challenges or dementia diagnosis

What are your biggest concerns right now?(Required)

Quality of care they'll receive

Feeling comfortable in this environment

Social engagement and avoiding isolation

Medical oversight and coordination

Maintaining dignity and independence

What's most important to you in choosing an assisted living community?(Required)

Small, intimate community

Medical insight thoughtfully integrated into care

Transparent, upfront pricing

Person-centered care approach

Beautiful, home-like environment

Strong family involvement and communication

Coordination between medical and daily care

What's your timeline for making a decision?(Required)

Immediate need (within 2 weeks)

Soon (1-2 months)

Exploring options (2-6 months)

Planning ahead (6+ months)

Name(Required)

Name

Email(Required)

Phone Number(Required)

Additional Notes (Optional)

Learn Your Support Level

Creating your Care Assessment