Planning Checklist for Caregiving Families Part 2

Home Safety

Steps, Stairways, and Walkways

Yes No

❑ ❑ Are they in good shape?

❑ ❑ Do they have a smooth, safe surface?

❑ ❑ Are there handrails on both sides of the stairway?

❑ ❑ Are there light switches at the top and bottom of the stairs?

❑ ❑ Is there grasping space for both knuckles and fingers on railings?

❑ ❑ Are the stair treads deep enough for your whole foot?

❑ ❑ Would a ramp be feasible in any of these areas if it became necessary?

Floor Surfaces

Yes No

❑ ❑ Is the surface safe?

❑ ❑ Is the surface nonslip?

❑ ❑ Are there any throw rugs or doormats that might slip underfoot?

❑ ❑ Is carpeting loose or torn?

❑ ❑ Are there changes in floor levels?

❑ ❑ If so, are they obvious or well marked?

❑ ❑ Do you have to step over any electric, telephone, or extension cords?

Driveway and Garage

Yes No

❑ ❑ Is there always space to park?

❑ ❑ Is it convenient to the entrance?

❑ ❑ Does the garage door open automatically?

Windows and Doors

Yes No

❑ ❑ Are windows and doors easy to open and close?

❑ ❑ Are locks sturdy and easy to operate?

❑ ❑ Do doorways accommodate a walker or wheelchair?

❑ ❑ Can you walk through the doorways easily?

❑ ❑ Is there space to maneuver while opening and closing doors?

❑ ❑ Does the front door have a view panel or peephole at the correct height?

Appliances, Kitchen, and Bath

Yes No

❑ ❑ Is the room arranged safely and conveniently?

❑ ❑ Do the oven and refrigerator open easily?

❑ ❑ Are stove controls clearly marked and easy to use?

❑ ❑ Is the counter the correct height and depth?

❑ ❑ Can you work sitting down?

❑ ❑ Are cabinet doorknobs easy to use?

❑ ❑ Are faucets easy to use?

❑ ❑ Do you have a handheld shower head?

❑ ❑ Are the items you use often on high shelves?

❑ ❑ Do you have a step stool with handles?

❑ ❑ Can you easily get into and out of the tub or shower?

❑ ❑ Do you have a bath or shower seat?

❑ ❑ Are there grab bars where needed?

❑ ❑ Is the water heater regulated to prevent scalding or burning?

Lighting and Ventilation

Yes No

❑ ❑ Are there enough lights, and are they bright enough?

❑ ❑ Do you have night lights where needed?

❑ ❑ Is area well ventilated?

Electrical Outlets, Switches, and Alarms

Yes No

❑ ❑ Can you turn switches on and off easily?

❑ ❑ Are outlets properly grounded to prevent a shock?

❑ ❑ Are extension cords in good shape?

❑ ❑ Do you have smoke detectors in all key areas?

❑ ❑ Do you have an alarm system?

❑ ❑ Do you use a personal emergency response system?

❑ ❑ Is the telephone readily available for emergencies?

❑ ❑ Does the telephone have volume control?

❑ ❑ Can you hear the doorbell ring throughout the entire house?

Emergency Preparedness Preparation Steps

❑ Check insurance policies for wind, flooding, fire, or other storm damage coverage

❑ Determine evacuation plan

❑ Plan for special assistance if mobility is an issue

❑ Register with local fire department

❑ Have an escape chair if in a high-rise building

❑ Register with utility company if using electrical medical equipment

❑ Have backup supply of oxygen

❑ Store cold packs for medication that needs refrigeration

❑ Prepare food for special dietary needs

❑ Pack food for service dogs

❑ Maintain a supply of water

❑ Prepare emergency kit

❑ Adult diapers

❑ Cash and coins

❑ Cell phone chargers

❑ Contact lens solution

❑ Credit/debit/ATM cards

❑ Directions to shelter or evacuation route

❑ Extra pair of glasses

❑ Extra prescription drugs

❑ Flashlight and extra batteries

❑ First aid kit and manual

❑ Hearing aid batteries

❑ Map of area

❑ Matches in waterproof container

❑ Moist towelettes

❑ Personal medication record

❑Portable battery-powered TV or radio

❑ Toilet paper

❑ Copies of important papers in waterproof/fireproof box

❑ Birth certificate

❑ Blank checks

❑ Passport

❑ Driver’s license

❑ Health insurance cards

❑ Insurance policies

❑ List of bank accounts

❑ List of credit/debit/ATM card numbers

❑ List of type and model numbers of medical equipment

❑ Marriage certificate

❑ Medical records

❑ Medicare card

❑ Personal property inventory

❑ Social Security card

❑ Printout of the checklists in this book

❑ Telephone tree of emergency contacts

❑ Designate an out-of-state person to be a point of contact

❑ Plan for care of pets

Safe Deposit Boxes

❑ The person I care for has the following safe deposit boxes:

Name of institution:

Phone: Fax:

Address:

Email: Website:

Box #: Key location: Box rent:

People who have access to the safe deposit box:

Items stored in this box:

Name of institution:

Phone: Fax:

Address:

Email: Website:

Box #: Key location: Box rent:

People who have access to the safe deposit box:

Storage Units

❑ The person I care for has the following public storage units:

Storage company:

Address:

Unit #: Website:

Username: Password/PIN: Monthly rent:

Autopay: Yes No Location of the key or lock combination:

Storage company:

Address:

Unit #: Website:

Username: Password/PIN: Monthly rent:

Autopay: Yes No Location of the key or lock combination:

Digital Assets

❑ The person I care for has designated to serve as agent to have access to digital assets. ❑ Usernames and passwords:

Facebook profile name:

Twitter profile name:

MySpace profile name:

Instagram profile name:

Computer password:

Smartphone password:

Tablet password:

Website:

Username: Password:

Website:

Username: Password:

Website:

Username: Password:

Website:

Username: Password:

Website:

Username: Password:

• For more information, go to www.aarp.org.

Sources: www.aarp.org

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