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Harland Mertz
DOX1466 OPAS 2145 PWD

93 yrs (6/3/1932)

07343 780355 / 0572310503

harland_mertz@example.com

NHS Number: 0557339197

Lives alone

Demographics missing

Primary Progressive Aphasia (PPA), diagnosed May 2024

AA: Advised to apply

Council tax: Waiting for AA

Driving: Informing

Blue badge: Not discussed

Health & wellbeing LPA: Not got capacity

Property & finance LPA: In place

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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 Harland Mertz (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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Harland Mertz DOX1466 OPAS 2145 PWD

Case Summary

Safeguarding Concern Form About the concern

Harland Mertz
DOX1466 OPAS 2145 PWD

Safeguarding Concern Form

About the concern