Memory Care Readiness Assessment

1

Disclaimer: This quiz is not a diagnostic tool. If you have concerns about your loved one’s memory or safety, please contact their doctor or a qualified healthcare professional for guidance.* This field is required.

2

First and Last Name* This field is required.

First Name

Last Name

3

Worry about my loved one’s safety when they are alone.* This field is required.

1
2
3
4
5

1 = No, not at all

5 = Yes, this always happens

4

My loved one has wandered, gotten lost, or left home unexpectedly.* This field is required.

5

Type a question

6

Daily tasks such as cooking, bathing, or dressing have become difficult for them.* This field is required.

7

I have noticed increased confusion about time, place, or familiar people.* This field is required.

8

They sometimes forget to take medication or take it incorrectly.* This field is required.

9

I, or other family members, feel emotionally or physically exhausted from caregiving.* This field is required.

10

My loved one’s mood or behavior changes frequently or becomes unpredictable.* This field is required.

11

They are becoming withdrawn or less interested in social activities they once enjoyed.* This field is required.

12

I often worry that I can no longer meet their care needs at home.* This field is required.

13

I have started researching or considering senior living or memory care options.* This field is required.

14

Drop your email below to see your score* This field is required.

example@example.com

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Results