Alice and Todd were very hesitant to talk to Alice’s parents. They had just finished the 12 Point Senior Living Assessment, and it didn’t go too well. There turned out to be red flags in pretty much every category, especially troubling were the physical safety questions. The neighborhood that Alice had grown up in now wasn’t considered a safe part of the large city.  The home would now need motion activated lighting outside as well as the improved locks noted.

Other areas that came to light were that her parents were hoarding expired medications. The elderly couple admitted that mom had fallen a few times, and they just didn’t want to bother anyone because she really wasn’t hurt. And the list went on. It now seemed to the Alice that it was only a matter of time and one of these issues would result in possibly a debilitating injury for her parents, or worse. It also seemed to the concerned daughter, that this over whelming list wasn’t going to be well received by her elderly parents.

The two couples sat down to go over the list together, and before they even got to the concerns over medications and nutrition. Mom smiled at them all and said “When do we leave?” It turned out that Mom and Dad had also been concerned about their many challenges that were piling up. Now that their daughter had opened the conversation, they were more than ready to make some big changes.

It turned out that her parents had always hoped to move to a warmer climate, to a senior living community. What they had needed was someone to step in and help them with the decision that the time was now. The four of them came up with a plan to check out some communities according to location, budget, and services. They wanted to make sure once settled they would not be having to make another move anytime soon. Once they found a place where they not only could have their own apartment, but also offered a continuum of care that they could add services as needed, they were ready to make the move.

A year later the elderly couple were happily settled. Mom had been the church organist for many years back home. Now she volunteered in the senior community to entertain on the keyboard during parties. Dad had joined the chess club, and they both were making use of the community pool. Alice was comfortable with this safe community where her parents now lived, but she was hanging on to that 12 Point Senior Living Assessment.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing


12 Point Senior Living Assessment (continued):

6.      Reduce the Risk of FALLS. This is always the place where the children or family will get more buy in for a home          assessment. Every senior knows of someone who fell and their life changed dramatically. And they are right,                the goal is not to fall, not to get hurt, not to have a fracture. The statistics show that a fall increases the                            likelihood of spending your remaining days and possibly years in a nursing home.

Are the floors free and clear of clutter, extension cords, piles of old mail, magazines, general debris, are there               scatter rugs? Are there motion activated night lights and adequate room lighting? Are there pets that dart                      around the indoor living space that could be under foot? And most of all, is there a history of falls, has this                    senior  fallen before? Do not assume that you would know if the senior has fallen, many a senior if able to get up          independently will not tell anyone they have fallen. The question must be asked.

Please go to the “search” button on this site and search “falls” or go to the falls category, this is a topic that                     cannot be over stated.

7.    Emergency – smoke detectors. Are there functioning smoke detectors? Is there a system in place to change the              batteries on a regular basis. As in Part I under cooking, this is the time to look for indications that something has       been  burnt – pot holders, dish towels, cutting boards, etc.

8.     Neighborhood safety. How close is the nearest neighbor, does the senior know the neighbor? Do you know the             neighbor? Would the neighbor be willing to check on your senior if you called them? Does the senior feel safe in           the neighborhood? Safe in their home? Safe going out at night? Does the senior, if they drive, feel safe going to              their car? This is the time to take a look at door locks and window security. Is there a system in place to ensure            that the senior cannot get locked out of their home by mistake?

9.     Water Temperature. Check the water temperature, make sure it is set below 120 degrees. As a person ages, they            may lose the ability to accurately feel water temperature due to diseases. Checking the water temperature on a             regular basis reduces the chance that this costly mistake will be made.

10.    Money Management. Are there stacks of bills sitting around or sitting in bags? Have you found money hidden               in interesting places? One elderly man decided to hide his money in a family Bible, to quickly forget where he               had hidden it. Are all of the seniors services in good working order, any indication that a service has ever been             interrupted?

11.     Does the senior have a healthcare/financial power of attorney in place? Is the power of attorney well informed            of the seniors wishes? Is there a living will? Make sure that if a decision has been made to have a “Do Not                       Resuscitate” form in place, that it is posted in a visible location if needed.

How often this assessment is completed is a judgement call. If the senior is very highly functioning, it will just give a heads up on what things to be looking out for. Over time, what started as an annual check can begin to be twice a year and for some areas, turn into monthly checks.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing



To have a geriatric assessment team visit the home of a senior can be expensive, and a luxury not always available, in every part of the country. Having your own assessment tool and annually checking areas of the senior’s life and environment can go far in keeping ahead of changes, and needs. If unable to complete the assessment at one visit, break it into smaller parts. The importance is to not rush through the assessment. But as you go through the assessment make notes and brainstorm corrections.

12 Point Senior Living Assessment Tool:

  1. Stairs, inside and outside the home. Are they in good repair, with adequate lighting and hand rails. Watch the senior go up and down the stairs, watching for signs of decreasing strength and balance. If the senior is in a wheelchair are ramps in place, is it difficult to maneuver in and out of doors and doorways?
  2. Bathroom assessment. Is the toilet a taller, chair height making it safer to transfer on and off. Are there ample and secure grab bars in locations where they will be of use to the senior? Many older people stop having a tub bath, and if they do not have a shower, they may switch to a sink bath. There should be a bath mat on the floor of the shower, a shower chair and supplies located in places of easy access. This is an area that also needs plenty of light.
  3. Medication storage and usage. A complete list of the senior’s medications should always be readily available. In an emergency situation, emergency personnel will want to know what medications the senior is taking. Where are medications stored? Are medications sorted into a daily medication container? Who is responsible for filling th container?  When you visit is the container on the right day and time indicating that the senior is taking their medication correctly? Is there a plan in place to check expiration dates and have a routine refill of prescription medications. Are refills delivered, or is there a plan in place for someone to pick them up?
  4.  Nutrition and cooking. Is there adequate food in the home? Is the food preparation area clean, are there cleaning supplies present? Are all of the appliances in working order? Are there any signs around of fire, burn pots and pans, burn areas of cutting boards, or dish cloths? Is there any evidence of spoiled food present? Who handles the trash and garage removal, does that system seem to be working well? Who does the grocery shopping, is there evidence of a balanced diet with fruit and vegetables available?
  5. Emergency numbers. Are emergency and family phone numbers posted by the phone, as well as programmed into the seniors’s phone?
  6. Home Temperature. Is the home warm in winter and cool in summer, is the equipment on a regular maintenance schedule?

Taking care of these issues on regularly scheduled visits will ensure that the senior can remain in their home, as well as give peace of mind to the family.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing