Wednesday, February 19, 2020

Choosing the Right Type of Housing or Care


Deciding which type of senior housing is most appropriate for yourself or an aging family member is not an easy task. The following assessment tool can help you determine which type of housing or care may be best. For each category below, please select the description that best describes the type of care needed by yourself or your loved one. Check only one option in each category. When finished, total the points from each category in the chart provided. The total score will give you a general idea about which type of housing or care would be most appropriate.


  • Capable of moving about independently. Able to seek and follow directions. Able to evacuate independently in case of emergency. 1 point
  • Ambulatory with cane or walker. Independent with wheelchair but needs help in emergency. 2 points
  • Requires occasional assistance to move about, but usually independent. 3 points
  • Mobile, but may require assistance due to confusion, poor vision, weakness, or poor motivation. 4 points
  • May require assistance when transferring from bed, chair, or toilet. 5 points
  • Requires transfer and transport assistance. Requires turning in bed and in wheelchair. 6 points


  • Able to prepare own meals. Eats without assistance. 1 point
  • Can do some meal preparation, but needs main meal prepared daily. 3 points
  • Needs all meals prepared and served. 4 points
  • May require assistance getting to meals and/or assistance when eating, such as opening cartons or cutting food. 5 points
  • May be mostly or totally dependent on others for nourishment (includes reminders to eat and/or assistance when eating). 6 points


  • Independent in all care including bathing, shaving, dressing. 1 point
  • May require assistance with bathing or hygiene or may require reminders or initiation assistance. 4 points
  • Dependent on others for most or all personal hygiene tasks. 6 points


  • Independent in performing housekeeping functions (including bed making, vacuuming, cleaning, and laundry). 1 point
  • May need assistance with heavy housekeeping, vacuuming, laundry, and changing linens. 2 points
  • Needs laundry and housekeeping services provided. 3 points


  • Independent and dresses appropriately. 1 point
  • May require assistance with shoelaces, zippers, medical appliances, or garments, or may require reminders, motivation, or initiation assistance. 4 points
  • Dependent on others for dressing. 5 points


  • Independent and completely continent. 1 point
  • May have incontinence, a colostomy, or catheter but is independent in caring for self through proper use of supplies. 2 points
  • May have occasional problems with incontinence, colostomy, or catheter care, or may require assistance in caring for self through proper use of supplies. 4 points
  • May be unwilling or unable to manage own incontinence through proper use of supplies or may require physical assistance with toileting on a regular basis. 5 points
  • Regularly and uncontrollably incontinent, dependent or unable to communicate needs. 6 points


  • Responsible for self-administration of medications. 1 point
  • Able to self-administer medications, but others may need to remind and monitor the actual process. 3 points
  • Family or home health agency has arranged a medication administration system with reminders and monitoring by family members or others. 4 points
  • Cannot administer own medications, even with supervision. Medications must be administered by licensed personnel. 6 points

Mental Status

  • Oriented to person, place, and time. Memory is intact but may have occasional forgetfulness with no pattern of memory loss. Able to reason, plan, and organize daily events. Has mental capacity to identify environmental needs and meet them. 1 point
  • May require occasional direction or guidance in getting from place to place, or may have difficulty with occasional confusion that may result in anxiety, social withdrawal, or depression. Orientation to time, place, or person may be minimally impaired. 3 points
  • Judgment may be poor. May not attempt tasks that are not within capabilities. May require strong orientation assistance and reminders. 5 points
  • Disoriented to time, place, and person, or memory is severely impaired. Usually unable to follow directions. 6 points

Behavioral Status

  • Deals appropriately with emotions and uses available resources to cope with inner stress. Deals appropriately with others. 1 point
  • May require periodic intervention from others to facilitate expression of feelings in order to cope with inner stress. May require periodic intervention from others to resolve conflicts and cope with stress. 3 points
  • May require regular intervention from others to facilitate expression of feelings and to deal with periodic outbursts of anxiety or agitation. 5 points
  • Maximum intervention is required to manage behavior. May pose physical danger to self or others, or is abusive or unacceptably uncooperative. 6 points
Number of Points
Mental Status
Behavioral Status
Total Score
Highest Score in Any Category

Interpretation of Scores

The total score will give you a general idea about which type of housing or care would be most appropriate for the person you are evaluating. The following score ranges show the typical levels of resident self-care at various types of senior residences or care facilities:

  • Residents of nursing homes point range: 34–50
  • Residents of assisted living facilities point range: 19–40
  • Residents of independent living–congregate senior housing communities point range: 13–23
  • Residents of independent living–senior apartments point range: 8–18

Perhaps the most important part of this scoring is to look at the highest scores you have selected. Certain physical conditions or needs for service can preclude a person from living in a particular type of senior care. For example, a person who needs 24-hour medical attention could not be admitted anywhere but a nursing home. A person who has regular incontinence problems would not be admitted to a congregate senior housing community.

If you score a 6 in any category, the most appropriate level of care will probably be a specially equipped assisted living facility or a nursing home.

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