Participant Assessment

Complete this checklist to determine if you and your loved one can benefit from the services of Grand Mere’s. 

Are you increasingly worried about the isolation or inactivity of a family member who:

Has lost interest in hobbies or trying something new? YesNo
Does not socialize or stay in touch with friends? YesNo
Needs something to do with his or her time? YesNo
Isn’t eating well unless you plan for or prepare meals? YesNo
Is alone a lot and doesn’t get out of the house much? YesNo
Is losing physical strength in part due to lack of exercise? YesNo
Is becoming increasingly dependent on your time and energy? YesNo
Needs regular health check-ups and does not take prescribed medication correctly without assistance? YesNo
Requires some assistance with daily care? YesNo
Is more and more confused or forgetful? YesNo
If you said “yes” to any of these questions, your loved one will benefit from quality care in the safe, supportive
environment at Grand Mere’s Adult Day Health Club.

Care Giver Assessment

Are you providing care for a disabled individual or responsible for this individual’s health & safety? If so:
Are you neglecting your own health? YesNo
Do you have outstanding errands on your “to-do list”? YesNo
Are you working or want to find a job but can’t because of your care giving responsibilities? YesNo
Do you feel overwhelmed, or like you’re falling behind? YesNo
Have you cut back on personal interests? YesNo
Do you keep postponing your visits with friends and family, or the class you have been thinking about? YesNo
Would rest from full-time care help you to be an even better caregiver? YesNo
Name                     Best Date to call you.  
Email                     Best time to reach you 
Contact Number    
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If you said “yes” to any of these questions, Grand Mere’s Adult Day Health Club can share the caring so that you can be at your best.
The loving, trained, and certified staff at Grand Mere’s Adult Day Health Club is waiting for your call!

Grand Mere’s Adult Day Health Club
1020 Eastbury Drive
Lansing, Michigan 48917
(517) 253-0784