Choosing Long-Term Care - Assess Your Needs

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Choosing Long-Term Care
Assess Your Needs
Custodial Care Check List
Will I need help with the following activities of daily living?
Bathing
Dressing
Eating
Using the bathroom, including caring for a catheter or colostomy bag if needed.
Moving into or out of a bed, chair, or wheelchair.
Other
Will I need help with these additional services?
Preparing meals
Shopping
Housework and laundry
Getting to appointments
Paying bills and other money matters
Home maintenance and repairs
Using the telephone
Will I need help with the following care?
Remembering to take medicines
Diabetes monitoring
Using eye drops
Getting oxygen
Taking care of colostomy or bladder catheters
Source: U.S. Department of Health and Human Services

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