Medical Alert Self-Assessment

A medical alert service gives older adults and those with chronic medical conditions the security and confidence to continue to live independently at the one place they feel most comfortable – in their own home.

Is it time to consider a medical alarm for you or someone you care for?
To find out answer the nine simple questions below.

Questions		Points
1.	Are you alone for several hours during the day or night?	2
2.	In the past year, have you fallen, been worried about falling, or otherwise been at risk of falling in your home?	3
3.	Have you been hospitalized, or been to the emergency room, in the past year?	2
4.	Do you have at least one of these chronic ailments: Heart Disease? Stroke? Chronic Obstructive Pulmonary Disease? Osteoporosis? Diabetes? Arthritis?	2
5.	Do you use a cane, walker, wheelchair, stair climber or other assistive device to help with balance or walking?	3
6.	Are you required to take several daily medications?	3
7.	Do you require assitance with at least one of the following activities: Bathing? Toileting? Dressing? Meal Preparation?	3
8.	Would a medical alert provide peace of mind for you or your loved ones?	1
9.	Is it important to you to continue living independently?	1
TOTAL POINTS		___

Determine Your Need
Your total points indicate the level of need for a medical alert service.
15-20 points – Urgent Need	A medical alert is likely to be recommended with some urgency by doctors, nurses and professional caregivers in this situation.
8-14 points – Elevated Need	A medical alert is likely to be highly recommended by hospitals, doctors, nurses and professional caregivers.
4-7 points – Moderate Need	Hospitals, doctors, nurses and professional caregivers might advise you to consider a medical alert.
0-3 points – Limited Need	A medical alert may not be required immediately, but re-evaluation is recommended as time goes on or the situation changes.
Important Note: Every situation is unique, so if you have any particular concerns, contact a trusted health professional, or call Lifeline at 785.452.6177.

To enroll or for more information, call Salina Regional Health Center Lifeline
785-452-6177 or
800-242-1306 - Ext. 4793