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Care Recipient Checkup

South Natick Dam
Wild flowers add a touch of color to South Natick Dam waterfall/Photo by Douglas Flynn

Caregivers want to provide the best care possible for their loved ones, but keeping track of all their care recipient's needs and monitoring their changing conditions can be a challenge.

This chart [PDF, 316KB] can be used to identify the current needs of the care recipient, creating a baseline. Over time if used weekly, monthly or quarterly, the chart can assist the caregiver to monitor changes in the health of the care recipient and to see any trends.

Learning the terms that healthcare professionals use to describe someone’s independence or need for assistance with tasks helps the caregiver advocate for the care recipient.  

Communicating the care recipient’s increased needs in terms of ADLs and IADLs will improve the physician’s and home care agency’s understanding of what is occurring and what additional services are needed to better serve the care recipient rather than a vague “he seems to be getting worse.”

Understanding the chart

ADL – Activities of Daily Living are bathing, dressing, eating, toileting and transferring in and out of a bed or a chair.

IADL – Instrumental Activities of Daily Living are housework, meal preparation, taking medications, grocery shopping, using the telephone and managing money.

Independent (0) – Elder can complete the task without any help.       

Limited Assistance (1) – Elder needs supervision for safety, verbal cues and/or some physical help completing the task.

Extensive Assistance (2) – Elder participates a little but needs significant help to complete the task.

By Others (3) – Elder is not able to help and needs others to perform the task.          

Note:  If physical violence is occurring toward the caregiver or the care recipient, then the situation is not safe and needs to change immediately. Please call 911 or Advocates Psychiatric Emergency Crisis Line (800-640-5432) to get help so that everyone remains safe.

Download or print the chart and evaluation questions [PDF, 316KB].

Contributed by Leslie May-Chibani©2014

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BayPath Elder Services, Inc

The BayPath Family Caregiver Support Program and has been made possible by funding from the Older Americans Act as granted by Executive Office of Elder Affairs. Participants may make a voluntary donation toward the cost of this federally funded service. Click here for more information. was originally made possible, in part, by generous grants from the MetroWest Health Foundation. Additional funding support was graciously donated by Avidia Bank from 2018 – 2021.

Thank you, MetroWest Health Foundation and Avidia Bank, for enabling BayPath Elder Services to provide support and resources to family caregivers.