PERS Questionnaire

It might be time for you or a loved one to get a Personal Emergency Response System (PERS) to help maintain independence and peace of mind. Take a moment to answer the following questions and refer to the recommendation below.

1. Is living independently important to you?

2. Do you need help with daily activities like preparing meals, bathing, using the bathroom OR getting dressed?

3. Do you take prescription medications daily?

4. Do you have any of the following ailments: heart disease, diabetes, arthritis, osteoporosis or stroke victim?

5. Have you fallen or been afraid of falling in the past 12 months?

6. Are you alone for multiple hours during the day or night?

7. Have you been hospitalized or been treated at the emergency room in the past 12 months?

8. Do you rely on a cane, walker, wheelchair or other device in order to walk or to keep your balance?

9. Do you have loved ones who would gain peace of mind from you having a PER system?

10. Do you ever worry that something might happen to you and you will not be able to get to a phone?

Your answers:

If you answered YES to 1-2 questions a PER system could really help you maintain your independence. You should think about what would happen to you if you fell today? Are you sure you would be able to get up? How would you call for help? How long could you potentially lie there before help arrived? We believe you should consider a PER system.

If you answered YES to 3-5 questions your potential for a fall or other medical incident is significant and a PER system could be very helpful and is highly recommended.

If you answered YES to 6-10 questions your potential for a fall or other medical incident is very high and we strongly recommend that you get a PER system to help keep your independence and provide you and those around you with peace of mind.

Call us at 507-288-5522 or 800-533-1602.