Home Health Care Assessment Quiz

Could Home Health Care Help?

If you’re an adult caring for your mom, dad or other family member with health care challenges, you’re not alone. Today in the United States, more than one in three Americans find themselves in the same position. It can be overwhelming for the entire family – especially if you don’t know where to turn for answers and support.

This quiz will create a personalized report to help you understand the risk factors for your mom, dad or loved one and if home health care may be able to help.

Question 1

Has your mom, dad or loved one been diagnosed with any of these conditions?








Question 2

Have they experienced any of the following in the past 3 months?







Question 3

Has your loved one been diagnosed with a terminal condition, with six months or less life expectancy?

This question is required.

Question 4

Has their doctor prescribed any of the following medications or treatments?








Question 5

Does your loved one have trouble keeping track of which medications they’re supposed to take, or have they accidentally taken the wrong medication or dosage?






Question 6

Do they have difficulty performing any of the following tasks?







Question 7

How often do they visit or call the doctor to deal with symptoms of their condition or side-effects from medication?






Question 8

How difficult is it for your loved one to leave home? Please select the option that best describes their current situation.






Question 7

What is the ZIP Code where your mom, dad or loved one lives? (required)

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