What Do You Need?
Do You Need Help... |
What Do You Want?
Is It Important for You To… |
Questions to Ask |
Walking?
Dressing?
Eating?
Bathing?
Toileting? |
Maintain your routines, such as deciding when to:
Get up?
Go to sleep?
Eat meals?
Bathe or shower? |
Can I decide when I:
Get up?
Go to sleep?
Eat breakfast, lunch, and dinner?
Shower or bathe? |
Cooking?
Doing laundry?
Housekeeping?
Reading?
Writing?
Paying bills? |
Spend your time:
Cooking?
Doing laundry?
Keeping house?
Entertaining?
Reading?
Writing social and business letters?
Doing something else? If so, what? |
If there’s a kitchenette, are the cupboards reachable?
If no kitchenette, what chances are there to prepare my own meals?
Is there a laundry for residents’ use?
Can I keep my own housekeeping supplies?
Can I get help doing my own laundry or housekeeping?
Can I have visitors at many times of day?
Can someone from the residence read to me?
Can someone read to me in my language if it isn’t English?
Are large-print books available?
Books on tape?
Are written materials from the residence, such as the admissions contract, house rules, newsletter, in large print?
Can someone from the residence help me write my letters? |
| Getting places? |
Go certain places, such as:
Supermarket?
Park?
Bank?
Department store?
Library?
Hardware store?
Museum?
Take trips?
Visit family and friends? |
What transportation is available
from the residence?
What options are there for
individuals to schedule outings
other than to medical appointments,
residence scheduled
trips, or other group trips?
What public transportation is
available, and is it accessible?
What’s within safe walking distance
for me? Shopping? Park? Library? Bank?
Do residents have a curfew?
What are the procedures if I
decide to stay overnight with a
friend or go on trips overnight? |
Maintaining your involvement in
your neighborhood and larger
community, such as:
Your church, mosque, or
synagogue?
Clubs and organizations you
belong to or volunteer for? |
Staying involved with
your neighborhood and
larger community? |
What are my chances to continue
my community activities,
such as attending my place of
worship, or clubs or organizations
I belong to?
What other opportunities are
there to engage in community
activities? |
And regular supervision from a
doctor or nurse because of a
medical condition?
Managing or taking your
medications? |
Be involved and have
a say in your medical
treatment? |
What opportunities are there
to be involved and have a say
in my medical treatment?
Can I refuse medications,
services or treatment? |
