Initial Assessment Visit And Care Planning

A North American Home Health Agency

1 Step 1
Here are some of the List Of The Care We Would Provide. (Additional timelines and instructions are Available for Senior Care Rules and Daily Schedule).
Please Indicate And Circle With Yes To Care You Need Or /Cross Out The Care You Do not Need;
Health Care (Medical)
These services Are To Be provided by a licensed therapist or nurse.
Speech therapy
Wound care or bandaging
Rehabilitative or therapeutic physical therapy
Occupational therapy
Medication Administration
Non Medical Care( Care Provided BY A Licenced ( HCA)
Medication prompting
Blood Pressure Checks
Ht An Wt Checks
Favorite Fruits
Change bed sheets
Straighten room, make bed
Personal Care
Assist with transfers (going from chair to bed, using the toilet, getting in and out of the bath, etc.)
Assist with bathing
Assist with toileting
Assist with dressing
Assist with walking
Assist with exercises
Assist with personal grooming (brushing hair or teeth, clipping fingernails or toenails)
Observe and record any health or behavior changes
Meals and Nutrition
Plan meals and snacks a day
Prepare food
Serve food
Provide company at mealtime
Assist with feeding
Clean dishes or put in dishwasher
Put away clean, dry dishes
Wipe surfaces of counters and stove
Activity of daily living
General Duties
(Service Provided By Home Maker)
Clean tub, toilet, sink
Care for pets
Empty trash in kitchen, bathrooms and bedroom
Sort recycling items
Secure home when leaving
General/thorough house cleaning
Water plants
Vacuum carpets and floors or sweep hard floors
Garden maintenance
Keep home surfaces clean, clutter-free and dusted
Grocery Shopping, Errands and Activities
Errands may include stops at the grocery store, drug store or gas station to purchase food and supplies
Put items away in the home
Arrange for alternate transportation (like a senior van) or public transportation
Medical or dental appointments
Beauty or personal care appointments
Social visits to family and friends
Faith-based visits
Social Pursuits
Going on walks or sitting outside
Reading out loud
Playing games (board, card, etc.)
General companionship and conversation
Thank You For Contacting Us We Look Forward To A Remarkable Relationship With You.
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