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LSQ – Ellenor CarePlan – Print
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2020-12-07T16:55:25-05:00
Ellenor Johnson
Unit 117 | Assisted Living
CarePlan
Quarterly Assessment | 04/12/20
Ellenor CP Top Completed
Top Completed
Assessment Type
14-day
30-day
Interim
Quarterly
Significant Change
Mental Status
(multi-select)
Alert and Oriented
Elopement Risk
Aggression – Physical
Aggression – Verbal
Uncooperative
Confused / Disoriented
Med Cart Assignment
Cart 1
Cart 2
Cart 3
Hospice
Date of 1st Hospice CarePlan
Submit
Ellenor CP Print
Bathing
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Evening
TUE
Morning
THU
Evening
SAT
Morning
Details
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Goal
Goal Details
Text
Bed
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Morning
Evening
MON
Morning
Evening
TUE
Morning
Evening
WED
Morning
Evening
THU
Morning
Evening
FRI
Morning
Evening
SAT
Morning
Evening
Details
Goal
Goal Details
Text
Blood Pressure
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
9a–12p
3p–6p
MON
9a–12p
3p–6p
TUE
9a–12p
3p–6p
WED
9a–12p
3p–6p
THU
9a–12p
3p–6p
FRI
9a–12p
3p–6p
SAT
9a–12p
3p–6p
Details
Goal
Goal Details
Text
Chair Stand
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Morning
MON
Morning
TUE
Morning
WED
Morning
THU
Morning
FRI
Morning
SAT
Morning
Details
Goal
Goal Details
Check-In
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Every 2 hrs
MON
Every 2 hrs
TUE
Every 2 hrs
WED
Every 2 hrs
THU
Every 2 hrs
FRI
Every 2 hrs
SAT
Every 2 hrs
Details
Goal
Goal Details
Dental
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Morning
MON
Morning
TUE
Morning
WED
Morning
THU
Morning
FRI
Morning
SAT
Morning
Details
Goal
Goal Details
Text
Dressing
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Morning
MON
Morning
TUE
Morning
WED
Morning
THU
Morning
FRI
Morning
SAT
Morning
Details
Goal
Goal Details
Text
Elopement
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Details
Goal
Goal Details
Text
Falls
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Details
Goal
Goal Details
Text
Glucose
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
6a–9a
MON
6a–9a
TUE
6a–9a
WED
6a–9a
THU
6a–9a
FRI
6a–9a
SAT
6a–9a
Details
Goal
Goal Details
Text
Grooming
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Morning
MON
Morning
TUE
Morning
WED
Morning
THU
Morning
FRI
Morning
SAT
Morning
Details
Goal
Goal Details
Text
Insulin
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
6a–9a
MON
6a–9a
TUE
6a–9a
WED
6a–9a
THU
6a–9a
FRI
6a–9a
SAT
6a–9a
Details
Goal
Goal Details
Text
Meals
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Bkfst
Lunch
Dinner
MON
Bkfst
Lunch
Dinner
TUE
Bkfst
Lunch
Dinner
WED
Bkfst
Lunch
Dinner
THU
Bkfst
Lunch
Dinner
FRI
Bkfst
Lunch
Dinner
SAT
Bkfst
Lunch
Dinner
Details
Goal
Goal Details
Text
Medication
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Details
Goal
Goal Details
Text
Mobility
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Details
Goal
Goal Details
Text
Skin
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Morning
MON
Morning
TUE
Morning
WED
Morning
THU
Morning
FRI
Morning
SAT
Morning
Details
Goal
Goal Details
Text
Toileting
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Details
Goal
Goal Details
Text
Vision
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Morning
MON
Morning
TUE
Morning
WED
Morning
THU
Morning
FRI
Morning
SAT
Morning
Details
Goal
Goal Details
Text
Broken Arm
Level of Assistance
Independent
Some Assistance
Assisted
Assigned to
Frequency
SUN
Morning
MON
Morning
TUE
Morning
WED
Morning
THU
Morning
FRI
Morning
SAT
Morning
Details
Goal
Goal Details
Text
Meeting Minutes / Signatures
Meeting Minutes
Submit
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