Risk Assessment Tool

Physical, psychological, social, spiritual, or environmental changes can signal that your loved one's quality of life is at risk. This tool is designed to assist you in identifying these significant changes so that you can take action to preserve your loved one's independence and lifestyle.

The changes underlined at the top of each section are the most serious and call for immediate action. However, any of the red flags listed should prompt loved ones to investigate the problem and consult a professional.

Please check each statement that applies to your loved one to get a complete look at their current situation.

Memory Impairment

Does your loved one:

Leave the stove, oven or iron on (potentially life-threatening)

Forget to take medication (potentially life-threatening)

Wander from home and have difficulty getting back (potentially hazardous to senior safety)

Miss appointments

Forget to pay bills

Hallucinate or have an altered mental status

Changes in Mobility

Does Your Loved One Have:

Frequent falls (potentially life-threatening)

Difficulty using a bathtub, shower or toilet (may precipitate a fall)

Difficulty walking

Difficulty using an assistance device such as a cane or walker

Difficulty climbing stairs

Difficulty getting out of chairs

Changes in Mood and Behavior

Does Your Loved One:

Seem to have lost interest in life (may signal major depression)

Talk about feeling hopeless (may signal major depression)

Experience frequent mood swings

Socially isolate themselves

Have decreased participation in such regular activities as church, clubs or social groups

Fear going outside the home

Changes in Sleep Patterns

Does Your Loved One:

Sleep most of the day

Experience Insomnia

Sleep poorly, or have interrupted sleep

Changes in Diet

Does Your Loved One:

Lack food in the home: empty cupboards or refrigerator (may jeopardize health)

Eat inappropriate or unhealthy food, or food that may worsen a medical condition such as diabetes or heart disease

Lack appetite or overeat

Experience noticeable weight gain or loss

Changes in Physical Appearance

Does Your Loved One:

Show signs of bodily injury - frequent or serious bruises, cuts, burns (may indicate physical abuse or serious injury)

Have abnormal skin color

Have shortness of breath

Have swollen feet or ankles (may indicate serious circulatory problems)

Experience weight changes (may indicate serious underlying health problem)

Have an unkempt appearance

Experience challenges maintaining daily hygiene

Wear the same clothes many days in a row

Changes in Household

Does Your Loved One Have:

Large amounts of unopened mail

Widespread clutter (in the home of a habitually tidy person)

Failure to do laundry or other basic cleaning tasks

An inability to care for the exterior of the home (yard maintenance, snow removal, etc.)