HomeBase Senior Care
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HOME CARE MATCHING

What kind of help is needed?

Tell us about the care situation. HomeBase will compare these needs against publicly documented agency capabilities and explain each match.

Search privately. You do not need to provide a name, phone number, email address, or create an account.
CARE QUESTIONNAIRE Step 1
01

Location and General Needs

Where is care needed? *
Enter the ZIP code where the person receiving care lives.
02

Personal Care

Help with everyday personal-care activities.

Is help with personal care activities needed? *
Examples include bathing, dressing, grooming and toileting.
03

Mobility

Does the person need help with mobility or transfers? *
04

Household Assistance

Help with meals and routine household tasks.

Is help with meals or household tasks needed? *
This can include cooking, laundry, housekeeping, shopping or errands.
05

Supervision and Companionship

Memory, safety, supervision and companionship needs.

Are memory, supervision or companionship needs present? *
This can include dementia, confusion, wandering risk or continuous supervision.
06

Special Situations

Experience that may be relevant to the care situation.

Would experience with a particular care situation be helpful? *
Specialized experience can help distinguish agencies, but please also select the actual functional care needs in the other sections.
07

Schedule

When is care needed? *
Choose the option that best describes when care should begin.
Approximately how many days per week is care needed? *
Enter a number from 1 through 7.
Approximately how many hours per day is care needed? *
An estimate is fine. Half-hour increments are allowed.
When during the day is care generally needed? *
Select all that apply.
Is respite care needed?
Respite care can provide temporary relief for a regular family caregiver.
08

Transportation

Transportation and caregiver-driving needs.

Is transportation assistance needed? *
For example, help getting to appointments, errands or other destinations.
09

Caregiver Preferences

Is there a preferred caregiver language?
This is a preference only. Current caregiver availability must be confirmed with the agency.
Is there a caregiver gender preference?
This is a preference and does not indicate current caregiver availability.
Are any other caregiver preferences important?
Preferences may not be verifiable against current caregiver availability.