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Two Minute Test

This brief questionnaire is designed to assist people worried about an elder. The questions gather information about an elder loved one's situation and identify appropriate actions. The risk classification generated does not substitute a formal assessment by a Professional Geriatric Care Manager. Elders with higher risk scores should obtain assistance soon.

Does your loved one have trouble bathing or dressing?

Does your loved one have trouble using the telephone?

Does your loved one have trouble keeping the house neat?

Are your loved one's caregivers having trouble meeting your loved one's needs?

Does your loved one have trouble walking even a short distance?

Does your loved one have trouble keeping the kitchen or pantry stocked?

Is your loved one losing weight?

Does your loved one have trouble taking medications?

Does your loved one have trouble paying bills or writing checks?

Does your loved one seem forgetful or confused?

Has your loved one seemed sad or lost interest in usual activities?

Are you worried about your loved one's safety?

Has your loved one been falling?

Does your loved one have trouble getting to or using the toilet?

Does your loved one have trouble getting in or out of bed or a chair?

Does your loved one have trouble eating?

Does your loved one have new bed sores?

Are you concerned about your loved one drinking alcohol or using other drugs?

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