Evaluation

Are you evaluating an older adult?

Select the appropriate answer to indicate if the person is having a problem with any of the following

Eating

Dressing

Walking around

Getting in or out of bed

Taking a bath or shower

Toileting

Using a telephone

Going out from home

Shopping

Cooking

Light house work

Taking medicines

Managing finances

Arthritis

Parkinson's disease

Glaucoma

Diabetes

Stomach problems

History of heart attack

Hypertension

History of stroke

Flu

Broken hip

Other broken bones

Trouble with bladder and/or bowels

Dementia

Self-rated health problems

Problems with vision

Problems with hearing

Problems with ears

Problems with teeth

Problems with feet

Results

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