Is It Time for Memory Care?
Patient Checklist For Primary Care Providers:
Assess When Home Care May No Longer Be Safe*
SAFETY RISKS
COGNITIVE DECLINE
BEHAVIORAL CHANGES
CAREGIVER STRESS
DAILY LIVING CHALLENGES
SCORING GUIDANCE
NEXT STEPS
WHY CHOOSE OUR MEMORY CARE?
DOWNLOAD THIS CHECKLIST
and share with families:
CONTACT OUR MEMORY CARE TEAM:
-I think that formatting this as a 1-page PDF makes for easy printing and sharing.
- Red flags (⚠️) will highlight high-risk items (e.g., wandering, aggression).
- Include our logo and tagline: “From Home to Haven: Your Partner in Dementia Care."
This checklist helps PCP's objectively identify when a patient’s cognitive decline requires specialized care, positioning your services as a trusted solution.
480-331-3604
Always consult with a neurologist or geriatrician for clinical guidance
- Smooth transition from home care with familiar staff.
- Specialized programs for agitation, wandering, and cognitive stimulation.
- Family support groups and monthly care plan reviews.
1. Discuss with family: Share this checklist to validate concerns.
2. Order a safety assessment: Contact us for a free in-home evaluation.
3. Explore options:
- In-home memory care (ideal for early-stage decline).
- Residential memory care (secure environment for advanced needs).
- 1–5 "Yes" Responses: In-home memory care may suffice with increased support.
- 6–10 "Yes" Responses: Strongly consider transitioning to a secure memory care residence.
- 11+ "Yes" Responses: Urgent need for 24/7 supervised memory care.
☐ Wandering/getting lost (even in familiar places).
☐ Frequent falls or unexplained injuries.
☐ Leaving appliances on (stove, oven, water running).
☐ Medication mismanagement (overdosing, skipping doses).
☐ Driving accidents or near-misses.
☐ Repeating questions or stories multiple times daily.
☐ Difficulty recognizing family/friends.
☐ Inability to follow simple instructions (e.g., dressing).
☐ Getting lost in familiar neighborhoods.
☐ Forgetting recent events (e.g., meals, visits).
☐ Aggression, paranoia, or hallucinations.
☐ Sundowning (increased agitation in evenings).
☐ Social withdrawal or loss of interest in hobbies.
☐ Hoarding or hiding objects.
☐ Incontinence without awareness.
☐ Family caregiver exhaustion (physical/emotional).
☐ Safety fears when leaving the patient alone.
☐ Sleep disruption (patient wandering at night).
☐ Resistance to care (refusing baths, meals).
☐ Poor hygiene (not bathing, wearing dirty clothes).
☐ Weight loss/malnutrition (forgetting to eat).
☐ Unpaid bills or financial mismanagement.
☐ Home clutter/unsanitary conditions
MEDICAL FACTORS
☐ Frequent hospitalizations (UTIs, dehydration, falls).
☐ Diagnosis of Alzheimer’s/dementia (moderate-severe).
☐ Comorbid conditions (diabetes, heart disease) worsening due to cognitive decline.
info@ardstrategies.com
480-331-3604 / 602-332-0780
© 2025. ARD Strategies a division of ARD Global Media Group, LLC All rights reserved.
We know that navigating senior care decisions can feel overwhelming, but you don’t have to do it alone. ARD Strategies is here to support and guide you every step of the way.