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Ezequiel Jacobi
DOX1270 OPAS 1949 PWD

76 yrs (13/9/1948)

080987379631 / 0710269529

ezequiel_jacobi@example.com

NHS Number: 8659271904

Demographics missing

Other mixed dementia, diagnosed Sep 2024

AA: Application declined

Council tax: Disregard granted

Driving: Awaiting assessment

Blue badge: Declined to apply

Health & wellbeing LPA: Not got capacity

Property & finance LPA: Alternative in place

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Carer

Anton Zulauf (client of professional carer)

DOX1271

OPAS 1950

78 yrs (24/10/1946)

0559539050 / 05592 688406

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Case Summary

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Background
Dementia Symptoms Experienced
Medication
Physical Health and Mobility
Diet and Nutrition
Care and Support
Social Engagement
Financial / Legal / Future Planning
Notes / Comments

Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Ezequiel Jacobi (the "Subject")

Summary of concern

Factual account of what was said or observed. Include dates, times and locations, the person's own words, descriptions of signs/symptoms etc. Refer to Policy for full guidance on recording.

Summary of any immediate actions taken

Eg. Were emergency services called? Any practical support offered etc.

Does the subject have care and support needs?

Eg. Physical or mental health condition

Notes about care and support needs

Do you feel the subject is able to make their own decisions about what happens next?

Notes about decision capabilities

What support / outcome does the subject want?

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Ezequiel Jacobi DOX1270 OPAS 1949 PWD

Case Summary

Safeguarding Concern Form About the concern

Ezequiel Jacobi
DOX1270 OPAS 1949 PWD

Safeguarding Concern Form

About the concern