Senior Care Decision Worksheet
Use it to separate care needs, safety gaps, family workload, cost, and the next smallest decision before choosing a care setting.
A senior care decision usually feels emotional because it is emotional. This worksheet gives the family a clearer way to compare options.
Quick answer
Use it to separate care needs, safety gaps, family workload, cost, and the next smallest decision before choosing a care setting.
When To Use This Worksheet
Use this when a family is deciding between:
- Staying home with family support.
- Adding paid home care.
- Trying adult day care.
- Moving to assisted living.
- Considering memory care.
- Considering nursing home care.
- Reassessing after a fall, hospitalization, or caregiver burnout.
Section 1: Current Care Snapshot
| Question | Answer | | --- | --- | | Who needs care? | | | Current living situation | | | Primary caregiver | | | Backup caregiver | | | Main safety concern | | | Main cost concern | | | Main family conflict or worry | | | Most recent triggering event | |
Section 2: Care Needs
Mark each item:
- Green = covered and stable.
- Yellow = covered but fragile.
- Red = unsafe, uncovered, or unsustainable.
| Care need | Green | Yellow | Red | Notes | | --- | --- | --- | --- | --- | | Bathing | | | | | | Dressing | | | | | | Toileting | | | | | | Meals | | | | | | Medication | | | | | | Transportation | | | | | | Housekeeping | | | | | | Mobility | | | | | | Falls | | | | | | Memory | | | | | | Wandering | | | | | | Nighttime safety | | | | | | Supervision | | | | | | Family caregiver capacity | | | | |
Section 3: Option Comparison
| Option | Monthly cost | Family hours/week | Safety fit | Backup plan | Biggest risk | | --- | --- | --- | --- | --- | --- | | Stay home, family care | | | | | | | Home care | | | | | | | Adult day care | | | | | | | Assisted living | | | | | | | Memory care | | | | | | | Nursing home | | | | | |
Kefiw Tip
Do not choose the option with the lowest cost first. Choose the option that does not fail on safety, backup coverage, or caregiver sustainability.
A plan that is cheap but depends on one exhausted caregiver is not actually cheap.
Family Discussion Prompt
"Let's compare these options by safety, cost, and workload, not by guilt, fear, or what we hoped would be true."
Decision Rule
Write the family's care rule:
"If ______ happens, we will reassess the care plan."
Examples:
- If there are two falls in 30 days.
- If medication is missed twice in one week.
- If the caregiver sleeps fewer than five hours for three nights.
- If home care reaches 40 hours per week.
- If wandering occurs.
Reusable Product Asset Uses
This worksheet should eventually support:
- Printable PDF.
- Saveable worksheet.
- Calculator result add-on.
- Care Track step.
- Family summary export.
- Email or share version.
- Bring-this-to-a-tour version when relevant.
- Use-before-a-family-meeting version when relevant.
Professional Review
Recommended reviewer: geriatric care manager, senior care advisor
Sources To Verify
- CDC: Steps for creating and maintaining a care plan
- NIH MedlinePlus Magazine: Caregiving worksheets from NIA
Last reviewed: April 29, 2026.
Kefiw Worksheet Disclaimer
Kefiw provides educational care-planning tools, worksheets, and guides. These materials are designed to help families organize information and prepare better questions. They do not replace medical, legal, financial, tax, insurance, employment, benefits, or professional care advice. Care needs, costs, coverage, provider quality, eligibility, and legal requirements vary by person, plan, provider, state, and situation. For urgent medical concerns or immediate danger, call emergency services.
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Related
Frequently asked questions
› How should families use this worksheet? How-to
Use it before a care decision, appointment, tour, provider interview, or family conversation so the discussion starts with facts instead of memory and stress.
› Is this worksheet professional advice? How-to
No. It organizes information and prepares better questions, but medical, legal, financial, tax, insurance, benefits, employment, and care decisions should be confirmed with qualified professionals.
› Should this be printed or saved? How-to
Both can help. A printed copy is useful during tours or family meetings, while a saved copy helps the family update the plan after care needs, costs, or safety risks change.
› How should I use this guide with a Kefiw tool? How-to
Use the guide as the plan and the linked Kefiw tool as the check. Read the steps first, try the move manually, then use the tool to compare outputs, catch edge cases, and decide whether the result actually fits your task.
› What mistake do tool guides help avoid? Troubleshooting
Tool guides help avoid using a utility mechanically without understanding what you are trying to accomplish. Most word, writing, and text utilities are fast, but speed can hide context mistakes. Know whether you are solving a puzzle, cleaning copy, drafting a line, or checking a rule.