Ready to Get Started?Who Needs Care at Home?(Required)Select…My SelfParentGrandParentOther RelativeFriendOtherHow Old is the Person Who Needs Care?(Required)Select…45-5455-6465-7475-8485 or olderMale or Female?(Required)Select…MaleFemaleWhat is their current living situation?(Required)Select…Living Alone at HomeLiving at Home with FamilyIn the Hospital Needs a SitterIn the Hospital Discharging to HomeAssisted LivingIndependent Senior LivingEstimate How Much Care They Might Need(Required)SelectA few hours per weekMore than 20 hours per week40 or more hours per weekAround-the-Clock CareLive-in CareWhat type of Care is Needed? (Check all that apply)(Required) Light housekeeping & laundry Meal preparation for seniors Medication reminders Companionship and conversation Transportation to errands or appointments House sitting and daily wellness check-insHow will care be paid for?(Required)Select…Private FundsLong-Term Care InsuranceMedicaidOther – (VA Aid and Attendace, Reverse Morgage, etc)Zip Code Where Care is Needed(Required)
