Guidelines for Determining Caregiving Needs

Level of Home CareUsing the ADL and IADL List, determine needs for care based on the following:

Independent:

  • Recommended Care
    • Recommended: socialization and minimal homemaking assistance, if desired. No other care needed.
  • Response in Emergencies
    • Independent in an emergency. Able to negotiate stairs in an emergency.
  • ADL Function
    • Able to accomplish all ADL without intervention.
      • Bathe and dress
      • Ambulate/walk
      • Toilet
      • Eat
      • Take medications
      • Communicate
  • Meals/Housekeeping
    • Meals/housekeeping assistance helpful.
  • Socialization
    • Able to independently plan social activities.
  • Mental Status
    • Oriented to self. No memory impairment.
  • Family Concerns
    • Does not medically “need” assistance or care.

Minimum Assistance

  • Recommended Care
    • Recommended 5 hours 2-4x/week for socialization and homemaking assistance.
  • Response in Emergencies
    • Able to respond in an emergency.
  • ADL Function
    • Walks/transfers independently. Infrequent falls. ADL: independent to verbal reminders. Independent w/medications and doctors’ appointments. Continent bowel/bladder. Independent baths.
  • Meals/Housekeeping
    • Meals/ nutrition/ housekeeping assistance helpful.
  • Socialization
    • Would benefit from socialization and activities. Minor encouragement.
  • Mental Status
    • Oriented to self. Little memory impairment.
  • Family Concerns
    • Family slightly concerned.

Stand-By Assistance

  • Recommended Care
    • Recommended 6–8 hours 4–7x/week for socialization, meals, personal assistance and homemaking.
  • Response in Emergencies
    • May need assistance in an emergency.
  • ADL Function
    • Transfer: stand-by assist may be needed.
    • ADL: reminders to verbal cues; medication mgmnt. helpful; occasional incontinence assistance; bathing set-up helpful.
  • Meals/Housekeeping
    • Meals/ nutrition/ housekeeping assistance helpful.
  • Socialization
    • Reminders/ encouragement to participate in activities.
  • Mental Status
    • Mild memory impairment. Sometimes disoriented.
  • Family Concerns
    • Family concerned.

Hands-On Assistance

  • Recommended Care
    • Recommended 8–12 hours 5–7x/week for socialization, meals, personal assistance and homemaking.
  • Response in Emergencies
    • Needs assistance in an emergency.
  • ADL Function
    • Transfer: one-person assist usually needed.
    • ADL: verbal cues to hands-on assist; medication management; incontinence management; bathing assistance needed.
  • Meals/Housekeeping
    • Meals/ nutrition/ housekeeping assistance needed.
  • Socialization
    • Encouragement/ escort to participate in social activities.
  • Mental Status
    • Impaired memory. Poor orientation. Mild confusion.

Total Assistance

  • Recommended Care
    • Recommended 24 hours 7x/week for safety, socialization, meals, full assistance and homemaking.
  • Response in Emergencies
    • Needs supervision in an emergency.
  • ADL Function
    • Transfer: mechanical lift/ two-person transfer/bedfast.
    • ADL: hands-on assistance; medication/behavior management; bathing assistance.
  • Meals/Housekeeping
    • Verbal cues/ hands-on assistance to eat.
  • Socialization
    • Encouragement/ escort to activities or one-on-one activities or visits.
  • Mental Status
    • Needs 24-hour supervision.
  • Family Concerns
    • Needs continuous assistance.

Wondering where your senior loved one falls on the level of care chart? Contact the senior care experts at CareWorks Health Services and we will be glad to work with you to ensure your loved one gets the right amount of in-home care that he or she needs.

Click here to download a printable PDF version of this chart.

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