Senior Care Technology Evaluation Checklist Form
Use this checklist to evaluate senior care technology for senior usability, caregiver workflow fit, safety, reliability, and overall adoption readiness.
Evaluation Scope and Context
Technology / Product Name
*
Vendor / Company Name
*
Technology Category
*
Please Select
Communication Tool
Monitoring System
Medication Reminder System
Fall Detection Device
Scheduling / Care Coordination Software
Telehealth Platform
Other
Version / Model (if applicable)
Evaluation Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Evaluator Name or Role
*
Care Setting Being Evaluated
*
Please Select
Home Care
Assisted Living
Nursing Facility
Memory Care
Other
Primary Use Case / Purpose of Evaluation
*
Senior Usability and Accessibility Review
Usability ratings
*
Rows
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
Ease of navigation
1
2
3
4
5
Readability of text and screen elements
6
7
8
9
10
Clarity of instructions
11
12
13
14
15
Suitability of controls for limited dexterity, vision, and hearing
16
17
18
19
20
Setup simplicity
21
22
23
24
25
Overall senior-friendliness
26
27
28
29
30
Is the interface suitable for seniors?
*
Please Select
Very suitable
Suitable
Needs improvement
Not suitable
Ease of navigation
1
2
3
4
5
Readability of text and screen elements
1
2
3
4
5
Clarity of instructions
1
2
3
4
5
Suitability for limited dexterity, vision, and hearing
1
2
3
4
5
Comments on usability issues observed
Caregiver and Staff Workflow Fit
Caregiver/staff usefulness
*
1
2
3
4
5
Task efficiency
*
1
2
3
4
5
Communication support
*
1
2
3
4
5
Training effort required
*
1
2
3
4
5
Workflow fit and interoperability
*
Rows
Poor
Fair
Good
Very Good
Excellent
Fits current workflow
31
32
33
34
35
Supports existing care processes
36
37
38
39
40
Integrates with current tools and systems
41
42
43
44
45
Reduces manual handoffs
46
47
48
49
50
Supports timely communication
51
52
53
54
55
Handles alerts and notifications well
56
57
58
59
60
Overall fit with current workflow
*
Please Select
Fully fits
Mostly fits
Partially fits
Does not fit
Workflow gaps or improvement notes
Safety, Reliability, and Support Review
Uptime and performance rating
*
1
2
3
4
5
Error or issue frequency
*
Please Select
Never
Rarely
Sometimes
Often
Very often
Safety concerns observed
Comfort with data and privacy handling
*
Low comfort
1
2
3
4
5
6
7
8
9
High comfort
10
1 is Low comfort, 10 is High comfort
Vendor support responsiveness
*
1
2
3
4
5
Recommendation status
*
Please Select
Recommend
Recommend with changes
Do not recommend yet
Key risks or required changes
Overall Verdict and Follow-up
Overall Rating
*
1
2
3
4
5
Summary of Strengths
*
Summary of Weaknesses
*
Priority Improvement Suggestions
*
Next-Step Decision
*
Approve for adoption
Pilot with revisions
Retest after fixes
Reject
Final Comments / Notes
Submit Evaluation
Should be Empty: