CARE SURVEY

When is it time to consider in-home assistance for your loved one? Our brief survey can help you better understand your loved ones' needs. Simply answer yes or no to the questions below, and an email will be sent to you with your results. Our dedicated care staff will review your answers and personally email you or call you (depending on your preferred form of communication) to discuss your care options. Central Penn is here to assist you in achieving peace of mind and to guide you to the right care that meets your family's needs.

CPNC Care Survey

1. Has your loved one lost their appetite or recently lost weight?
2. Does your loved one have specific dietary needs and require assistance with meal preparation?
3. Has your loved one lost interest in changing out of their bed clothes for the day?
4. Are there times that your loved one struggles to communicate their needs or seems confused?
5. Has your loved lost interest in their appearance or daily hygiene? Forgetting or refusing to wash up, brush their teeth, comb their hair or change out of dirty clothes?
6. Does your loved one struggle with daily chores of a household? Laundry, light housekeeping, changing linens?
7. Has your loved one become socially withdrawn, possibly communicating less with family or friends?
8. Have you noticed unexplained bruising, possibly from an unreported fall?
9. Does your loved one need daily reminders to take their medications correctly?
10. Is your loved one afraid to be alone in their home?
11. Do you have concerns around their overall health and wellbeing, safety, nutrition, hygiene or social interactions?
This field is for validation purposes and should be left unchanged.