Care Needs Signposting

Please think about your needs and capabilities and answer the questions below. Read the questions carefully and consider the level of care you needs give it a score in the box provided (0 is no help and 10 is a lot of help). There are five blocks of questions in all and you must complete all 5 blocks of questions to receive an indication of the type of care that may be appropriate for you.

What level of assistance do you need to meet the requirements of daily living:

Assistance with walking

Getting in or out of bed

Bathing

Dressing

Feeding

Using the lavatory

Preparation of special diets

What level of assistance do you need with non medical problems:

Night care

Incontinence

Supervision during the waking day

What is the level of any disability you may have:

How physically robust are you

Are all your limbs active and useable

How well can you move from place to place

How reliant are you on a mobility aid

How is your overall sensory perception (Sight etc)

What level of cognition to you enjoy:

How is your memory

Do you get confused sometime

What level of medical support do you need:

What level of assistance do you need with medication

What level of assistance do you need from your GP or community nurse

How reliant are you on hospital care and visits