Client Assessment

Helping us support our clients in the best possible way

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- Step 1 of 8

About the client

Preferred name / nickname:

Date of birth:

Address:

Emergency contact (name, relationship, phone number x 3):

Do they live alone or with others?

Do they have pets? (If yes, what kind?)

General Health & Wellbeing

How would they describe their overall health at the moment?

Does the client have any long-term health conditions? (e.g. arthritis, diabetes, heart conditions)

Has the client had any recent hospital stays or falls?

Are there any health issues that particularly affect their day-to-day life?

Is there anything they worry about regarding their health?

Medication

Does the client take regular medication?

Are medications managed independently, with reminders, or by someone else?

Does the client use a pill organiser/blister packs?

Any known allergies or medication sensitivities?

Any side effects carers should be aware of?

Mobility & Physical Support

How do they usually get around?

Independently
With walking aid
With wheelchair

Do they need support with:

Standing up / sitting down?
Stairs?
Getting in and out of vehicles?

recent get use

Have they had any falls in the past 12 months?

What makes moving around easier or more comfortable for them?

Personal Care & Daily Living

Do they need support with:

Washing or bathing?
Dressing?
Toileting?
Meal preparation?

Are there any routines they like to keep?

Is there anything they prefer to do themselves, even if it takes longer?

Communication & Cognitive Support

Do they have any hearing or vision difficulties?

Do they use glasses or hearing aids?

Do they experience memory difficulties or confusion?

Are there times of day they feel more tired or unsettled?

What helps them feel calm and reassured?

Interests, Hobbies & Enjoyment

What hobbies or activities do they enjoy or used to enjoy?

Do they like:

Reading?
Puzzles or games?
Gardening?
Crafts or knitting?

Are there any activities they would like to try again with support?

Music, Film & Television

Favourite type of music or artists?

Are there songs or music that bring back happy memories?

Favourite films or film genres?

Favourite TV programmes (past or present)?

Do they enjoy watching together or prefer quiet background TV?