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Serving Plymouth, Norfolk & Bristol Counties
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You are here: Home / Needs Assessment Questionnaire

Needs Assessment Questionnaire

Here are some simple questions to ask yourself to see if you should meet with a home care agency for a professional assessment of your needs and complimentary care plan.

1.  Is your house clean enough to meet your high standards?

  • Yes
  • No

2.  Are there chores around the house the you cannot currently do or that are becoming too much?

  • Yes
  • No

3.  Are you eating well enough consistently?

    • Yes
    • No

4.  Are you keeping your doctor appointments?

    • Yes
    • No

5.  Are you able to drive to your appointments as well as drive to all of your shopping needs (grocery/pharmacy)?

  • Yes
  • No

6.  Are you feeling overwhelmed taking care of your spouse?

  • Yes
  • No

7.  Are your children worried about you being alone or that taking care of your spouse is too much?

  • Yes
  • No

8.  Are you taking care of yourself everyday (exercise, proper diet, keeping your own doctor appointments, doing something fun a couple of times a week)?

  • Yes
  • No

9.  Would it be a benefit to have some assistance or companionship during the week?

  • Yes
  • No

 

Answer Key:

If you answered YES to questions #2, #6, #7 or #9 or NO to #1, #3, #4, #5 or #8 you should consider our services.

Only a few hours of professional caregiving each week can make a huge difference in your health and enjoyment of life. With Cottage Caregivers you can get just two hours a week to 24-hours a day – to support your independent life in your own home.

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    Home Care in Plymouth, Norfolk and Bristol Counties Massachusetts

    Hingham, Scituate, Marshfield, Cohasset, Quincy, Weymouth, Braintree, Duxbury, Plymouth, Hanover, Norwell, Abington, Rockland, Whitman, Canton, Milton and more!

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    Serving South Shore & Southeastern MA

    Address:
    Cottage Caregivers
    51 Mill Street
    Building #8
    Hanover, MA 02339

    Cottage Caregivers
    73 Smoke Hill Ridge Road
    Marshfield, MA 02050

    Office Hours:
    Monday-Friday
    8:30am-5pm

    Phone:
    781-430-8599

    Email:
    info@cottagecaregiverscom.wpcomstaging.com

    Fax: 781-430-8592

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      This agency is a member of Companion Connection Senior Care, a national organization of non-medical home care agencies. All members have access to recognized experts in the field of homecare, as well as the most current educational resources, enabling them to provide the highest level of care.