William Donnelly
DOX941 OPAS 1620 PWD

09762 926099 / 0528704162

maryellen_labadie@example.com

NHS Number: 6976061568

AA: Not yet eligible

Council tax: Applied/applying

Driving: Awaiting assessment

Blue badge: Advised to apply

Health & wellbeing LPA: Not got capacity

Property & finance LPA: Not discussed

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1 ended relationship: Agatha Corwin (civil partner)

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Background

PWD's personal background e.g. who are they, what did they do, what do they enjoy etc.

Dementia Symptoms Experienced

What effect is dementia having on their memory and behaviours? Are they aware of the diagnosis (insight)?

Medication

What dementia medication are they taking? How are they finding it? Who assists? Do they have a blister pack?

Physical Health and Mobility

How physically healthy / mobile are they? Any falls? Any sensory impairment? Any assistive/preventative tech in place? Personal care?

Diet and Nutrition

Care and Support

Will appear below list of carers. How are they coping? Is the support fit for purpose?

Social Engagement

Also include any volunteer befrienders here

Financial / Legal / Future Planning

Will appear below 'Core Advice' on summary

Notes / Comments

Anything else to include on the case summary

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