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Is Assisted Living Right for You or Your Loved One?
Take our quick online assessment to learn more about your options and get personalized answers if Assisted Living is the right choice for you/your loved one, in under 5 minutes.
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1
Hi. To get started, can you tell us who is it you are researching senior living for?
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Myself
A Loved One
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2
How old are you?
*
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55-65
66-75
76-85
Older
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3
Please tell us about your current living situation.
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4
Alright, now let's talk about why you think it might be time for you to consider a move to an assisted living community.
*
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You can choose more than one.
It Might Be Time to Consider Downsizing.
I am Concerned that My Care Needs are not Being Met.
I am Worried About a Recent Change (e.g., Loss of a Partner, an Injury, a Medical Diagnosis).
I am Worried About Loneliness or Isolation.
I am Feeling a Little Overwhelmed and Could Use Some Help.
I Worry About Safety Because of Health or Memory Issues.
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5
Do you think having assistance with any daily tasks may be helpful in your day?
*
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You can choose more than one.
Getting Dressed
Restroom Assistance
Personal Hygiene Routine
Assistance with Showering/Bathing for Safety Reasons
None of These
I'm Not Sure
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6
Do you have any trouble managing and taking medications?
*
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YES
NO
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7
Do you have any trouble walking?
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YES
NO
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8
What activities would you like to fill your day with?
*
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You can choose more than one.
A Cup of Coffee or Tea
A Walk or Other Physical Activity
A Good Meal
Connecting with Friends and family
Being with Pets
Being Outdoors
Spiritual or Faith-Based Activities
TV, Movies or Music
Quiet Time on My Own
Other Interests or Hobbies
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9
Other interests or hobbies
Please specify
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10
Are there any medical conditions or diagnoses that cause concern or need management?
*
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You can choose more than one.
None
Yes, But I Manage This on My Own
Yes, and I Need Occasional Assistance
Yes, I need Daily or Regular Access to Medical Care
I'm Not Sure
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11
Are you aware of changes in memory and/or thinking?
*
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YES
NO
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12
How open-minded are you about considering a senior living community?
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I’m Open to It
I Need to Talk About it More and Get More Information
This would be Difficult
I'm Not Sure
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13
Are you financially prepared for a move?
*
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YES
NO
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14
Are other family members or friends helping with this decision?
*
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YES
NO
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15
Are you interested in talking with an expert at The Arbors/Ivy about options that might be a good fit for you?
*
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YES
NO
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16
How old is your loved one?
*
This field is required.
55-65
66-75
76-85
Older
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17
Please you tell us about your loved one's current living situation.
*
This field is required.
Huge
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Normal
Small
Ok
quote
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Ok
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18
Alright, now let's talk about why you think it might be time for your loved one to consider a move to an assisted living community.
*
This field is required.
You can choose more than one.
It Might be Time to Consider Downsizing.
I am Concerned That His/Her Care Needs are Not Being Met.
I am Worried About a Recent Change (e.g., Loss of a Partner, an Injury, a Medical Diagnosis).
I am Worried About His/Her Loneliness or Isolation.
I think He/She is Feeling a Little Overwhelmed and Could Use Some Help.
I Worry About His/Her Safety Because of Health or Memory Issues.
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Submit
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19
Does your loved one need help with any of these personal care activities?
*
This field is required.
You can choose more than one.
Getting Dressed
Restroom Assistance
Personal Hygiene Routine
Assistance with Showering/Bathing for Safety Reasons
None of These
I'm Not Sure
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Enter
20
Is he/she having trouble managing and taking medications?
*
This field is required.
YES
NO
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Enter
21
Does he/she have any trouble walking?
*
This field is required.
YES
NO
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Submit
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Enter
22
What activities would you like to fill his/her day with?
*
This field is required.
You can choose more than one.
A Cup of Coffee or Tea
A Walk or Other Physical Activity
A Good Meal
Connecting with Friends and Family
Being with Pets
Being Outdoors
Spiritual or Faith-Based Activities
TV, Movies or Music
Quiet Time
Other Interests or Hobbies
Back
Next
Submit
Press
Enter
23
Other interests or hobbies
Please specify
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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Submit
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Enter
24
Are there any medical conditions or diagnoses that cause concern or need management?
*
This field is required.
You can choose more than one.
None
Yes, But They Manage This on Their Own
Yes, and He/She needs Occasional Assistance
Yes, He/She Needs Daily or Regular Access to Medical Care
I'm Not Sure
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25
Do you notice changes in his/her memory and/or thinking?
*
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YES
NO
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26
How open-minded is your loved one about considering a senior living community?
*
This field is required.
He/She is Open to It
I Need to Talk About it More and Get More Information
This Would Be Difficult
I'm Not Sure
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27
Is your loved one financially prepared for a move?
*
This field is required.
YES
NO
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28
Are other family members or friends helping you with this decision?
*
This field is required.
YES
NO
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29
Are you interested in talking with an expert at The Arbors/Ivy about options that might be a good fit for your loved one
*
This field is required.
YES
NO
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30
Ok, someone will reach out with more information. Tell us how to get in touch:
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31
Name
*
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First Name
Last Name
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32
Email
*
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example@example.com
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33
Phone Number
*
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Please enter a valid phone number.
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34
What's Your Preferred Contact Method?
You Can Choose More Than One
Text/Email
Phone Call
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