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Who Needs Care at Home?
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Myself
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Male or Female?
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What is their current living situation?
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Living Alone at Home
Living at Home with Family
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Assisted Living
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Nursing Home
In Hospital Discharging to Facility
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Estimate How Much Care They Might Need
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A few hours per week
More than 20 hours per week
Around-the-Clock Care
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What Type of Care is Needed? (Check all that apply)
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Companionship Care (light housekeeping, meal preparation)
Personal Care (bathing, hygiene, dressing, ambulation)
Continuous 24/7 Care
Alzheimer’s and Dementia Care
Transitional Care
Post Operation care & Home Recovery
Skilled Nursing Care
Transportation to Appointments
Medication Reminders
Respite Care
Hospice Care
Other
Where Care is Needed?
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Lakeland
Winter Haven
Plant City
Auburndale
Bartow
Haines City
Mulberry
Davenport
Lake Wales
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