Client Care Preferences — Adult Best Care

Completed by a family member?

Pace — What pace of care do you prefer? Choose all that apply

Fast and efficient care Slow and patient care

Independence Level — How much help do you need day to day? Choose all that apply

I need help with most things I need help with certain activities I don't need help but would like nearby support

Privacy Preferences — How much personal space would you like your caregiver to give you? Choose all that apply

As much as possible; unless needed Nearby and involved most of the time

Caregiver Gender Preference — Do you prefer a male or female caregiver? Choose all that apply

Male Female No preference

Lifting Assistance — How much lifting or transfer assistance do you need? Choose all that apply

Initiative — How should your caregiver approach daily tasks? Choose all that apply

Take initiative and suggest what needs to be done Follow my instructions and lead

Temperament — What kind of energy do you prefer in a caregiver?

Very calm, quiet, lowkey energyVery upbeat, bubbly, high energy

Social Preferences — How much conversation do you enjoy?

Solitude / quietChatty / engaged

Daily Rhythm — When are you most active?

Early riserNight owl

Communication Type — How would you like your caregiver to communicate with you? Choose all that apply

Direct, straightforward communication Soft and gentle communication

Humor Style — What kind of humor do you enjoy? Choose all that apply

Playful, Satirical Dry, Deadpan Witty Wordplay / Puns Serious and Earnest

Interests and Activities — What activities would you like to do together? Choose all that apply

Cultural Background — How important is cultural familiarity? Choose all that apply

Cultural background doesn't matter to me I prefer a caregiver who understands my culture and cuisine

Tidiness Preferences — How clean do you like your home kept?

Relaxed and lived-inShiny and spotless

Pets in the Home — Do you have pets in your home? Choose all that apply

No pets Dog(s) Cat(s) Other pets

Home Standards — Which home standards should your caregiver follow? Choose all that apply

No smoking in/around the house Fragrance free or minimal cologne/perfume Shoes off in home Quiet environment (no loud music, T.V., etc.) Special dietary rules (religious/medical)

Political Alignment — How important is it that your caregiver shares the same political views?

Don't careMust align

Spiritual Practices — How important is it that your caregiver shares the same spiritual beliefs?

Not importantCentral to my life

Matching Flexibility — How closely should your caregiver align to your preferences?

Match must be just rightI can adjust