1 Your Care Needs Who Needs Care? Myself A Loved One Relationship to you? Mother Father Mother in law Father in law Grandfather Grandmother Wife Husband Female partner Male partner Daughter Son Sister Brother Male Relative Female Relative Male friend Female friend Where is Care needed? Describe the care receiver Please upload a photo of yourself What daily activities do you need help with? Check all that apply Transferring Washing / Bathing Shopping Companionship Driving Cleaning Washing Up Computer Work Organisation Meal Prep Toileting Feeding Outings Dressing Laundry Paperwork Gardening Medication Management Tell us about any specific medical conditions? Check all that apply Visual Impairment Stroke MS ADHD Depression Autism Motor Neurone Disease Schizophrenia Orthopaedic Injuries Vascular Dementia Spinal Injury Care Anxiety Physical Disability Deafness Aspergers Learning Disability Traumatic Brain Injury Cerebal Palsy Alzheimers Dementia Parkinsons HIV Terminal Illness Eating Disorders Cancer PDD Diabetes None What are their likes & hobbies? Choose a maximum of 5 Animals Cooking Dining Out Books & Reading Gardening Movies & Cinema Arts & Culture Conversation & Debate Travel Music Concerts / Gigs Museums / Galleries Entertaining Health & Fitness Outdoor Activities Socialising Arts & Crafts Shopping Current Affairs Watching Sport Playing Sport Cards Business Knitting Volunteer Work Continue to Step 2. Schedule
