Scientifically, our bodies begin to "age" after thirty.  At some point during this aging process, we begin to have more difficulty performing everyday activities.  At what point do we need to be concerned about the capabilities of an older adult and consider putting services in place?

To zero in on a person's abilities, one needs to make careful observations.  Consider for a moment what triggered the initial concern. The following assessment tool can assist individuals in determining the appropriate resources to utilize. It may be necessary to consult a health care or case manager for assistance with the assessment.  Resources are defined as follows:

• Assistance with Daily Living:  Homemaker, Personal Care Attendant
• Housing Options:  Assisted Living, Senior Apartment, Nursing Home
• Health Care Services:  Home Health; nursing assistance, physical/occupational therapy
• Community Involvement:  Adult Day Care, Meals on Wheels, Transportation
• Legal and Consumer:  Attorney, Conservators, Vulnerable Adult Report
• Financial Assistance: Medical Assistance, Sliding Fees, County Subsidized Programs
• Support For Caregiver: Respite Services, Support Groups  

Observations	Indications	Resources
Cognitive
Consistently forgetful of appointments and commitments	May indicate memory loss or sensory impairments.  May lead to vulnerable adult issues, requiring a Power of Attorney or Guardianship.  May lead to problems in other areas of daily living	Assistance with Daily Living Housing Options Health Care Services Legal and Consumer
Difficulty in recognizing familiar   surroundings	May require supervision to attend to daily activities. Depending on severity of memory loss, may require supervised setting	Health Care Services Assistance With Daily Living    Housing Options
Confusion with medications or non-compliance with directions	May be due to vision difficulty or memory impairment. Could be due to lack of funds	Health Care Services Assistance with Daily Living Housing Options Financial Assistance
Roaming or wandering	May require supervised setting or companion care	Housing Options Assistance with Daily Living Community Involvement

Observations	Indications	Resources
Behavioral Changes
Older adult talks about their desire to die, or feel they are a burden.	May indicate depression or social isolation.	Health Care Services. Assistance with Daily Living. Community Involvement.
Older adult has become more verbally or physically belligerent.	May indicate physical ailment or medication side effects. Can lead to vulnerable adult concerns.  May lead to safety concerns.	Assistance with Daily Living. Health Care Services. Housing Options. Legal and Consumer.
Sensory Changes
Saying "what?" a lot, turning volume up, or staring vacantly while others talk.	May indicate hearing loss or medical disease; can lead to avoidance.  Can lead to vulnerable adult issues.	Assistance with Daily Living. Health Care Services.
Squinting, pulling back to read small print, difficulty driving at night	May indicate vision impairment or medical disease. May create safety concerns or lead to isolation. Can lead to vulnerable adult issues.  May require assistance with legal and financial forms.	Health Care Services. Assistance with Daily Living. Housing Options. Legal and Consumer.
Physical Changes
Soiled clothing or neglected appearance.	May indicate poor hygiene, incontinence, and inability to properly care for self due to memory or physical impairment.	Health Care Services. Assistance with Daily Living. Housing Options.
Adult has lost or gained significant amount of weight.	May indicate physical impairment or medication side effect.  May indicate depression, or memory impairment.  This could also be indicative of lack of funds or difficulty with cooking and/ or grocery shopping.	Health Care Services. Assistance with Daily Living. Financial Assistance. Community Involvement. Housing Options.
Unsteady gait. Repeated falls.	May need Physical Therapy for muscle strengthening, may require assistive device (cane or walker).	Assistance with daily living. Housing Options. Health Care Services.
Difficulty chewing, swallowing or frequent choking	May indicate physical impairment or need for dental check; can lead to nutritional concerns.  May require evaluation from speech therapist	Health Care Services.
Bruises on arms or legs.	May indicate falls due to unsteady gait or physical ailment.  Could indicate vulnerable adult issues.	Health Care Services. Assistance with Daily Living. Legal and Consumer. Housing Options.

Observations	Indications	Resources
Daily Living
Isolation due to inclement weather.	May be due in part to adult's inability to drive or to clear safe pathway.	Assistance with Daily Living. Community Involvement. Housing Options.
Adult has difficulty manipulating utensils and kitchen aids.	May be due to physical impairments could require occupational therapy and adaptive equipment. If not addressed can lead to nutritional concerns.	Health Care Services. Assistance with Daily Living.
Difficulty cooking or using appliances safely.	This may occur due to memory impairment.  Might need to shut off gas line due to safety concerns. May need homemaker to assist with meals or Meals on Wheels.	Assistance with Daily Living. Health Care Services. Housing Options. Community Involvement.
Difficulty grocery shopping.	May be due to inability to access transportation, lack of funds or physical impairment.  Can lead to nutritional concerns.	Assistance with Daily Living. Health Care Services. Community Involvement. Financial Assistance.
Difficulty house cleaning.	May be due to poor physical condition or home environment.	Assistance with Daily Living. Health Care Services. Housing Options.

Observations	Indications	Resources
Adult is unable to drive or access public transportation.	May require companion services to transport or transportation services.	Assistance with Daily Living.
Difficulty maintaining yard or house.	May be unable to manage physical labor, may indicate need to address housing situation.  May indicate lack of funds.	Assistance with Daily Living. Housing Options. Financial Assistance.
Bills are not being paid on time, unable to balance checkbook or unable to account for spending.	May be due to lack of funds requiring financial assistance or be due to confusion and forgetfulness indicating the need for a Power of Attorney.  May indicate deficiencies in other areas.	Financial Assistance. Legal and Consumer.
Caregiving Concerns
Caregiver is ill or unable to attend to needs.	May leave the older adult vulnerable, requiring community assistance.	Support for the Caregiver. Health Care Services.