Text Box: A personal emergency response system can help you foster independence and Text Box: Use this risk factor scoring system to help determine your level of need for a Personal Emergency Response System. Text Box: It is important to note that this self assessment is only intended as a general guideline to identify the need for a personal emergency response system. Please contact a trusted health professional if you have any concerns. 18 to 25 points – Imperative You are in the highest risk group and a personal emergency response system is likely to be advised to be important by health professionals and caregivers. 9 to 17 points – Elevated You are in a high risk group and a personal emergency response system is likely to be advised to be needed by health professionals and caregivers. 4 to 8 points – Modest You are in a moderate risk group and a personal emergency response system may be suggested for peace of mind by health Text Box: Are you alone for extended periods of time during the course of a day? If yes, add 2 points to your score. Do you use mobility assisted devices such as: canes, walkers, wheelchairs or stair lifts? If yes, add 3 points to your score. Do you require assistance in performing 2 or more activities of daily living? Examples: dressing, bathing, toileting, meal preparation, etc. If yes, add 4 points to your score. Are you physically frail or often experience weakness? If yes, add 2 points to your score. Have you fallen down or been anxious about falling in the past 12 months? If yes, add 3 points to your score. Have you been hospitalized or to the emergency room in the past 12 months? If yes, add 3 points to your score. Do you have a complex medication regime? If yes, add 2 points to your score. Do you have one or more of the following chronic medical issues: arthritis, COPD, heart disease, stroke, diabetes, osteoporosis, or depression? If yes, add 4 points to your score.