Observational Checklist for a Home Visit

Are you visiting a patient in his or her home?

Does the home appear suitable and safe for the patient?

Are problems noted in the presence or attitudes of other persons living in the home?

Are there problems noted in the proximity or attitudes of neighbors and relatives?

Are there adequate arrangements for emergency assistance?

Does the person have adequate nutritional habits and resources?

Is there evidence of alcohol or drug abuse?

Are there unexpected problems in the patient's daily living skills?

Are there problems in the person's hygiene or personal care habits?

Are there any safety or convenience modifications that might benefit the patient?

Does the patient have adequate access to stores and local services?

Is the patient taking medications appropriately, especially prescription drugs?