Dorey R. Service Plan Notes

Client Admission Date: 2/28/2020

DNR ON FILE

Last Date Reviewed: 03/02/2020

Location Notes: Room #202. Will need to ring a bell for the night shift to answer. You may also call this number (281) 370-5444.

Summary: Doris is a resident of Atria Cypresswood but now needs a caregiver to be with her at night for safety. She suffers from mild memory loss. We are there to assist her with nightly and morning grooming, toileting, ambulation and transferring. Ask for the assistance of the staff to work with you if she is weak and a fall risk.

Allergies: None

Stated Medical Condition

• Memory loss

• Weakness

• Fall Risk

Is the client on hospice?: No

Is the client on home health?: No

Date of Birth: 5/12/1935

Height and Weight:

Pets: No

Smoker: No

Dress Code: Blue scrubs with name tag

Is Cell Phone Use Allowed?: Not where client or family can see and after all duties are finished.

Is Sleeping Allowed?: No

Personal Care

• See Service Plan and detailed list of ADL’s in the blue folder.

• Medication Reminders: No

• Toileting:

  • Wears depends. Toilets in the bathroom.

  • Transfer her to wheelchair. In the restroom, she can hold the bar while you move the wheelchair out of the way. Pivot her to the toilet.

• Bathing: No

• Dressing:

  • Morning and evening assistance

• Routine Skin and Hair:

  • Groom as needed

• Shaving and Oral Care:

• Transfer:

  • Transfer to and from wheelchair and bed for ambulation

• Walking: No

• Exercising: No

Housekeeping and Personal Services

• Meal Preparation: No

• Feeding: No

• Cleaning: See detailed list of cleaning tasks on Page 2 and 3 of Service Plan in the blue folder.

• Laundry: No

• Shopping: No

• Escort: No

Likes and Dislikes

• See Getting to Know You document in the blue folder. Please contribute regularly.

Notes

• Emergency Contact Information found in the blue folder.

• Goes by Dorey. Real name is Doris.

Updates:

• 3/1/2020 - The blue folder is on top of the fridge under the basket.