Caregiver Care Plan

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I. Introduction

Welcome to the Caregiver Care Plan designed to provide comprehensive support and guidance for caregivers tasked with assisting individuals with diverse healthcare needs. This personalized plan serves as a roadmap, outlining essential information, strategies, and resources to ensure the well-being and safety of both the caregiver and the individual under their care.

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II. Personal Information

Name: [Your Name]

Age: [Patient's Age]

Gender: [Patient's Gender]

Medical History: [Medical Conditions]

Contact Information

Address: [Your Address]

Email: [Patient's Email Address]

Emergency Contacts

• [Primary Emergency Contact Name] - [Primary Emergency Contact Phone Number]

• [Secondary Emergency Contact Name] - [Secondary Emergency Contact Phone Number]

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III. Medical Needs

Diagnosis: Dementia

Medications:

• Donepezil (Aricept) - 10mg daily

• Metformin - 1000mg twice daily

• Lisinopril - 20mg once daily

Allergies: None

Dietary Restrictions: Low sodium diet

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IV Activities of Daily Living (ADLs)

Bathing

• Requires assistance, and prefers showers.

Dressing

• Partial assistance is needed, selects clothes independently.

Grooming

• Minimal assistance is required and needs reminders to brush their teeth.

Eating

• Independent but requires supervision due to forgetfulness.

Mobility

• Uses a walker, and needs assistance with stairs.

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V. Emotional Support

• Responds well to familiar routines and soothing music.

• Engage in reminiscence activities to stimulate memory.

• Encourage participation in light exercises and social interactions.

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VI. Safety Measures

• Remove tripping hazards and install grab bars in the bathroom.

• Ensure medication compliance with a pill organizer.

• Keep emergency numbers posted near the phone and programmed into speed dial.

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VII. Care Schedule

Morning	Assist with bathing and grooming. Administer morning medications. Prepare breakfast (low sodium).
Afternoon	Monitor for signs of fatigue or confusion. Encourage hydration and offer healthy snacks.
Evening	Supervise dinner (low sodium). Administer evening medications. Assist with nighttime routine and ensure safety in bed.

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VIII. Contact Information

Primary Care Physician: [Physician's Name]

Phone: [Physician's Phone Number]

Specialist: [Specialist's Name]

Phone: [Specialist's Phone Number]

Home Health Agency: [Agency Name]

Phone: [Agency Phone Number]

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IX. Emergency Plans

• In case of a medical emergency, call 911.

• Notify the primary contact immediately.

• Keep a copy of the Caregiver Care Plan readily accessible for emergency responders.

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