Care Calculator

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Care Services

If potential care charges are something you’d like to learn more about…let us help you plan with this estimate tool.

With this online basic healthcare assessment, we aim to give you a general idea of what you can expect to pay for care upon moving into Cooperwood Senior Living. This is fairly brief, but it will provide a personalized estimate for you or your loved one in a matter of minutes.

Initials(Required)

Type Initials in box

Acknowledgment(Required)

By completing this online care calculator, I understand this is strictly reflective of estimated care needs, and not a comprehensive assessment performed by a medical professional. These are approximations and therefore not binding as care fees may vary and are subject to change without prior notice. Other costs including the base rental rates for various apartment types are not included in the price herein; they will be provided separately.

Is this for yourself? Or is it for a loved one?(Required)

Myself

My loved one

There are many healthcare services we can provide; we call them Activities of Daily Living (ADLs). Which of the following meet your current needs? Choose as many as are applicable.(Required)

Bathing

Hygiene

Dressing

Mobility

Continence

Eating

Telephone

Shopping

Transportation

Medications

Mental Status

Health Status

I Don't Need Any Assistance

Select all that apply

Hmm, maybe assisted living isn’t the right fit right now.

Bathing(Required)

Independent - no assistance required.

Set up for shower and/or bathing articles; reminders as necessary.

Requires moderate assistance - requires significant amounts of assistance.

In addition to set up, requires stand by assistance into/out of shower for safety reasons (unsteadiness, etc.).

Full assistance needed with bathing; helping individual in and out of shower, complete washing and drying of body

Please select which of the following best describes your current health care needs as it relates to bathing (or showering).

How many times per week?(Required)

Please enter a number greater than or equal to 1.

Hygiene(Required)

Independent - no assistance required

Set up needed, including reminders to bathe, shave, comb hair, clip nails, brush teeth, insert dentures

In addition to set up, needs stand by assistance, usually involving reminders or preparation of grooming activities

Requires moderate assistance such as steadying of hands when shaving or combing hair, clipping nails

Full assistance required in all aspects of hygiene

Please select which of the following best describes your current health care needs as it relates to hygiene.

Dressing(Required)

Independent - no assistance needed

Assist with clothing, zippers, buttons, or shoes

Set up clothing daily, assist with clothing, zippers, buttons or shoes. Assist with braces, compression hose or splints

In addition to set up, needs moderate assistance with putting on/taking off clothing and shoes or hose

Full assistance required with dressing

Please select which of the following best describes your current health care needs as it relates to dressing.

Mobility(Required)

Independent- No assistance needed

Not always reliable - needs occasional in-room supervision and/or escort to/from dining room

In addition to set up, requires stand by assistance into/out of shower for safety reasons (unsteadiness, etc.)

Requires single-person transfer from chair, bed or toilet to wheelchair. Not likely to maneuver wheelchair.

Requires two-person transfer from chair, bed or toilet to wheelchair due to weight or for safety

Please select which of the following best describes your current health care needs as it relates to incontinence mobility.

Continence(Required)

Independent - no assistance required

Requires moderate assistance to manage continence. Includes assistance to/from bathroom, toileting checks at night

Requires full assistance to manage continence. Includes schedule for toileting, supervision while on toilet and assistance in cleaning

Please select which of the following best describes your current health care needs as it relates to continence.

Eating(Required)

Total independent-needs no special assistance or special diets OR requires minor assistance opening jars

Requires moderate assistance - requires special cup or utensils OR requires significant amounts of assistance

Requires special diet including soft mechanical, special liquids or foods or sodium restrictions

Please select which of the following best describes your current health care needs as it relates to eating.

Telephone(Required)

Independent - no assistance required

Individual is able to answer telephone, but needs staff to initiate calls

Individual unable to use telephone, depends on staff to receive all incoming message and make all calls

Please select which of the following best describes your current health care needs as it relates to telephone.

Shopping(Required)

Individual or individual's family take care of all needs

Family does some shopping

Full assistance required- facility does all shopping

Please select which of the following best describes your current health care needs as it relates to shopping.

Transportation(Required)

Uses facility vehicles, family provides transportation or resident drives own car

Requires handicapped or medical transport vehicle for transportation, facility make arrangements

Please select which of the following best describes your current health care needs as it relates to transportation.

Medications(Required)

Individual has routine or PRN orders for 0 to 2 treatments (eye drops, duragesic patches, creams and salves) per day

Individual has routine or PRN orders for 3 to 4 treatments per day

Individual has routine or PRN orders for 5 to 6 treatments per day

Individual has routine or PRN orders for 1 to 6 prescribed and/or over the counter medications per day

Individual has routine or PRN orders for 7 to 10 prescribed and/or over the counter medications per day

Individual has routine or PRN orders for 10 to 13 prescribed and/or over the counter medications per day

Individual has routine or PRN orders for 14 or more prescribed and/or over the counter medications per day

Individual uses oxygen; either full-time or part-time

Individual requires more than monthly blood pressure checks

Individual requires AccuChecks or other diabetes-related treatments

Please select any of the following that best describe your current health care needs as it relates to medications.

We are happy to discuss any more complex medication services you may need, including nebulizers, sprays, etc. Please contact the Community for more information on these services and pricing.

Mental Status(Required)

Appropriately oriented in person, place and time.

Mild impairment - some confusion, difficulty in remembering details in conversations, forgetfulness

Moderate impairment - memory loss, especially of current events - may be anxious and/or agitated about this

Severe impairment affecting all areas of judgement - requires constant orientation program

Abnormal impairment affecting all areas of judgement - may display paranoid or schizophrenic behavior

Please select which of the following best describes your current health care needs as it relates to transferring.

Health Status(Required)

In good general overall health with no serious difficulties preventing independent living

Stable chronic conditions - occasional flare ups but generally conditions are not life threatening

Unstable chronic conditions where flare-ups occur frequently; including, but not limited to, diabetes

Acute or life threatening conditions temporarily resulting in bed rest with good hope for recovery

Terminal illness, a state of dying with comfort care only. Generally a hospice situation

Please select which of the following best describes your current health care needs as it relates to transferring.

Almost done! Please fill out some basic information about yourself or your loved one, before your customized basic assessment is provided. Thank you for taking the time to fill this out, we appreciate your interest in our Community. Please call with any questions, we are glad to be of service.

Name(Required)

First Last

Email(Required)

Phone(Required)

Comments

Estimates are intended to give you a basic idea of what care services cost at our community. Your actual rate may vary depending on the results of your comprehensive, in-person assessment. These assessments help us tailor services to individual needs and are among the factors we consider in determining and monitoring staff levels.

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