Care needs assessment checklist
Before you can plan care or compare options, you need an honest picture of what help is needed and how often. Rate each activity, add notes, and print the summary. It is a good starting point for a conversation with a doctor, social worker or care agency.
This checklist describes everyday help needs; it is not a medical or social-care assessment and does not decide eligibility for any funding. Many countries offer a formal needs assessment through local health or social services — ask for one.
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Care needs assessment checklist
Personal care (activities of daily living)
Basic self-care. Needing help here usually means daily hands-on support.
- Bathing or showering
Level of help: Not rated
- Dressing and undressing
Level of help: Not rated
- Using the toilet
Level of help: Not rated
- Getting in and out of bed or a chair
Level of help: Not rated
- Managing continence
Level of help: Not rated
- Eating (not cooking)
Level of help: Not rated
Running the household (instrumental activities)
Tasks needed to live independently. Help here can often be shared among family or arranged a few times a week.
- Taking medicines on time
Level of help: Not rated
- Preparing meals
Level of help: Not rated
- Housekeeping and laundry
Level of help: Not rated
- Shopping and errands
Level of help: Not rated
- Getting to appointments and out of the house
Level of help: Not rated
- Paying bills and managing money
Level of help: Not rated
- Using the phone and keeping in touch
Level of help: Not rated
Safety, memory and mobility
Risks that shape how much supervision is needed.
- Remembering appointments, the stove, locking the door
Level of help: Not rated
- Walking safely without falling
Level of help: Not rated
- Being safe alone at night
Level of help: Not rated
- Being left alone for several hours
Level of help: Not rated
Summary
- Independent
- 0
- Some help
- 0
- Full help
- 0
17 activities not yet rated.
What are ADLs and IADLs?
Activities of daily living (ADLs) are basic self-care tasks: bathing, dressing, toileting, moving between bed and chair, continence and eating. Instrumental activities (IADLs) are the tasks needed to live independently: medicines, meals, housekeeping, shopping, transport, finances and communication. Care assessments and many insurance or benefit rules use these lists.
How often should we repeat the checklist?
Every few months, after a hospital stay, a fall or any noticeable change. Keeping the dated printouts shows how needs change over time, which helps doctors and care planners.
Does this decide what care or funding my relative gets?
No. It helps you describe needs clearly. Eligibility for funded care is decided by a formal assessment from your local health or social services or insurer, and the rules differ by country.