Medium

Available on

Apple Android Windows

Respite Elder Care Checklist Mobile App

Everyone needs a break. If you are a caregiver, you may need a break from care giving tasks. If you have dementia, you may want a break from the daily routine and have the opportunity to meet others who share some of the same challenges. Respite care can help, by providing a new environment or time to relax. Use the Respite Elder Care Checklist mobile app when you are screening different respite care options to find out if the provider, service or care setting will meet your needs. If it’s helpful, make copies of this list and use it to take notes about the different care options you explore. This list is not comprehensive, but may serve as a starting point for you to think of additional ideas, preferences and priorities.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Respite Elder Care Checklist Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico date

    Date

  • Ico textbox

    Patient

  • Ico textbox

    Patient Medical ID

  • Ico textbox

    Respite Facility

  • Ico textbox

    Location

  • Ico textbox

    Respite Worker

  • Ico textbox

    Title

  • Ico signature

    Signature

  • Ico statictext

    Checklist for help in the home or home care provider

  • Ico checkbox

    Offers the specific services you need

  • Ico checkbox

    companionship: visiting, supervision and leisure activities

  • Ico checkbox

    personal care: help with bathing, dressing, toileting and exercising

  • Ico checkbox

    homemaking: housekeeping, shopping and cooking

  • Ico checkbox

    skilled care: help with medication and other medical needs

  • Ico statictext

    Provider is

  • Ico checkbox

    able to communicate in the preferred language, if important

  • Ico checkbox

    trained in first aid and CPR

  • Ico checkbox

    trained in dementia care

  • Ico checkbox

    experienced in working with someone with dementia

  • Ico checkbox

    with an agency, if important

  • Ico checkbox

    bonded (protects clients from potential losses caused by the employee), if important

  • Ico checkbox

    able to provide references

  • Ico checkbox

    available when you need them

  • Ico checkbox

    able to provide a back-up if they are sick

  • Ico checkbox

    able to manage your specific health and behavioral care needs (list below)

  • Ico multiline

    List the needs you are most concerned about

  • Ico multiline

    Additional concerns:

  • Ico statictext

    Checklist for adult day care center

  • ...and More!

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