{"id":625,"date":"2000-08-02T12:00:00","date_gmt":"2000-08-02T12:00:00","guid":{"rendered":"https:\/\/care-givers.com\/articles\/carerecipient-profile-for-all-caregivers\/"},"modified":"2021-06-29T20:22:40","modified_gmt":"2021-06-29T20:22:40","slug":"carerecipient-profile-for-all-caregivers","status":"publish","type":"post","link":"https:\/\/care-givers.com\/articles\/carerecipient-profile-for-all-caregivers\/","title":{"rendered":"Carerecipient Profile For All Caregivers:"},"content":{"rendered":"
\n\n\n
Name of Care Recipient: _____________________<\/p>\n

Please call me: ___________________<\/p>\n

My Day Begins at: _______________<\/p>\n

The tasks I need help with are as follows:<\/p>\n

____________________________________________________________________________<\/p>\n

____________________________________________________________________________<\/p>\n

____________________________________________________________________________<\/p>\n

____________________________________________________________________________<\/p>\n

____________________________________________________________________________<\/p>\n

____________________________________________________________________________<\/p>\n

The best time of the day for me is: _________________________________________________________<\/p>\n

The most difficult time of the day for me is: _______________________________________<\/p>\n

I usally end my day around: ____________________________________________________<\/p>\n

The following are tasks I need help with:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

Meals:<\/p>\n

Breakfast:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

Lunch:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

Dinner:<\/p>\n

___________________________________________________________________________<\/p>\n

__________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

In between snacks:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

My favorite beverage is:___________________________________________________________<\/p>\n

I like my coffee or tea prepared: ______________________________________________________<\/p>\n

I also enjoy: __________________________________________________________________<\/p>\n

Special dietary needs:<\/p>\n

__________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

Special utensils :________________________________________________________________<\/p>\n

Foods I am allergic or sensitive to are:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

Foods I don’t like are:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

My favorite food preferences are:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

I enjoy eating my meals served in (room): _____________________________________________________<\/p>\n

I enjoy my caregiver eating with me: Yes __________ No _ _____<\/p>\n

My favorite restaurants (and you may order out from them) are:<\/p>\n

Name: ___________________________Address: _______________________________________<\/p>\n

Name: ___________________________Address: _______________________________________<\/p>\n

Name: ___________________________Address: _______________________________________<\/p>\n

Name: ___________________________Address: _______________________________________<\/p>\n

For list of family, personal contacts, physicians and other professionals, please read our
\nemergency information list.<\/p>\n

Things I need help with\u00a0(please describe):<\/p>\n

Keeping Clean and presentable: ______________________________________________________<\/p>\n

Toileting: ____________________________________________________________________<\/p>\n

Bathing: _____________________________________________________________________<\/p>\n

Waling: _____________________________________________________________________<\/p>\n

Climbing Steps: ________________________________________________________________<\/p>\n

Getting in and out of bed: __________________________________________________________<\/p>\n

Housework: ___________________________________________________________________<\/p>\n

Making and receiving phone calls: ____________________________________________________<\/p>\n

Walking: ___________________________________________________________________<\/p>\n

Taking medications: _____________________________________________________________<\/p>\n

Transportation: __________________________________________________________________<\/p>\n

Shopping ____________________________________________________________________<\/p>\n

Eating: ______________________________________________________________________<\/p>\n

Cooking: ____________________________________________________________________<\/p>\n

I am most comfortable wearing: ______________________________________________________<\/p>\n

__________________________________________________________________________<\/p>\n

Going out to an appointment I like to wear:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

Going out on an errand I like to wear:<\/p>\n

___________________________________________________________________________<\/p>\n

While in my home I like to wear:<\/p>\n

___________________________________________________________________________<\/p>\n

Going to church or temple I like to wear:<\/p>\n

___________________________________________________________________________<\/p>\n

___________________________________________________________________________<\/p>\n

Special appliances, health care items, or aids I use:<\/p>\n

Wig: ____________________ Makeup: ___________________ Cane: ________________<\/p>\n

Walker: ____________________Wheelchair: ___________________ Mobile chair: _____<\/p>\n

Eyeglasses: ____________________Incontinence pads \/ adult diapers: _____________<\/p>\n

Hearing Aid: ___________________ Dentures: ______________Oxygen: ____________<\/p>\n

Commode: ____________________ Walker: _________________________________<\/p>\n

Special shoes, socks, etc.:_______________________________________________<\/p>\n

Other:_________________________________________________________________<\/p>\n

_<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Crafts and hobbies<\/td>\n.<\/td>\n<\/tr>\n
Television Programs<\/td>\n.<\/td>\n<\/tr>\n
Radio Programs<\/td>\n.<\/td>\n<\/tr>\n
Music<\/td>\n.<\/td>\n<\/tr>\n
Exercise<\/td>\n.<\/td>\n<\/tr>\n
Musical Instruments
\nplayed<\/td>\n		.<\/td>\n<\/tr>\n
Languages spoken<\/td>\n.<\/td>\n<\/tr>\n
Favorite topics for
\nconversations<\/td>\n		.<\/td>\n<\/tr>\n
Meaningful life
\nexperiences<\/td>\n		.<\/td>\n<\/tr>\n
Travel experiences<\/td>\n.<\/td>\n<\/tr>\n
Memorable childhood
\nexperiences<\/td>\n		.<\/td>\n<\/tr>\n
Marriage<\/td>\n.<\/td>\n<\/tr>\n
Family<\/td>\n.<\/td>\n<\/tr>\n
Religous & Spiritual
\nbackground<\/td>\n		.<\/td>\n<\/tr>\n
Accomplishments<\/td>\n.<\/td>\n<\/tr>\n
Other interests<\/td>\n.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

I am involved in the following community programs:<\/p>\n

——————————————————————————————————————————-<\/p>\n

——————————————————————————————————————————-<\/p>\n

——————————————————————————————————————————-_<\/p>\n

My disposition:<\/p>\n

Caregivers enjoy caring for me because:<\/p>\n

________________________________________________________________<\/p>\n

________________________________________________________________<\/p>\n

Caregivers have difficulty with me because:<\/p>\n

________________________________________________________________________________________________<\/p>\n

________________________________________________________________________________________________<\/p>\n

 <\/p>\n\n\n\n\n\n\n\n\n
Name of medication or vitamin<\/td>\n,<\/td>\n<\/tr>\n
Form: liquid, tablet, capsule, injection, breathing treatment, bandage change, etc.<\/td>\n.<\/td>\n<\/tr>\n
Dosage<\/td>\n.<\/td>\n<\/tr>\n
Times given:<\/td>\n_____times per day at _____________________________________<\/td>\n<\/tr>\n
Taken with fluid, after food or before eating<\/td>\n,<\/td>\n<\/tr>\n
Special instructions<\/td>\n,<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n\n\n\n\n\n
Name of medication or vitamin<\/td>\n,<\/td>\n<\/tr>\n
Form: liquid, tablet, capsule, injection, breathing treatment, bandage change, etc.<\/td>\n.<\/td>\n<\/tr>\n
Dosage<\/td>\n.<\/td>\n<\/tr>\n
Times given:<\/td>\n_____times per day at _____________________________________<\/td>\n<\/tr>\n
Taken with fluid, after food or before eating<\/td>\n,<\/td>\n<\/tr>\n
Special instructions<\/td>\n,<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n\n\n\n\n\n
Name of medication or vitamin<\/td>\n,<\/td>\n<\/tr>\n
Form: liquid, tablet, capsule, injection, breathing treatment, bandage change, etc.<\/td>\n.<\/td>\n<\/tr>\n
Dosage<\/td>\n.<\/td>\n<\/tr>\n
Times given:<\/td>\n_____times per day at _____________________________________<\/td>\n<\/tr>\n
Taken with fluid, after food or before eating<\/td>\n,<\/td>\n<\/tr>\n
Special instructions<\/td>\n,<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n\n\n\n\n\n
Name of medication or vitamin<\/td>\n,<\/td>\n<\/tr>\n
Form: liquid, tablet, capsule, injection, breathing treatment, bandage change, etc.<\/td>\n.<\/td>\n<\/tr>\n
Dosage<\/td>\n.<\/td>\n<\/tr>\n
Times given:<\/td>\n_____times per day at _____________________________________<\/td>\n<\/tr>\n
Taken with fluid, after food or before eating<\/td>\n,<\/td>\n<\/tr>\n
Special instructions<\/td>\n,<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n\n\n\n\n\n
Name of medication or vitamin<\/td>\n,<\/td>\n<\/tr>\n
Form: liquid, tablet, capsule, injection, breathing treatment, bandage change, etc.<\/td>\n.<\/td>\n<\/tr>\n
Dosage<\/td>\n.<\/td>\n<\/tr>\n
Times given:<\/td>\n_____times per day at _____________________________________<\/td>\n<\/tr>\n
Taken with fluid, after food or before eating<\/td>\n,<\/td>\n<\/tr>\n
Special instructions<\/td>\n,<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>","protected":false},"excerpt":{"rendered":"

This profile gives the caregivers all of the needs, likes and dislikes of care recipients. This is a form every caregiver should use.<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[],"ppma_author":[38],"class_list":["post-625","post","type-post","status-publish","format-standard","hentry","category-aging"],"authors":[{"term_id":38,"user_id":6,"is_guest":0,"slug":"gail-mitchell","display_name":"Gail Mitchell","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/?s=96&d=mm&r=g","author_category":"","first_name":"Gail","last_name":"Mitchell","user_url":"","job_title":"","description":"

Ms. Mitchell began her full-time caregiving experience in the early eighties when her husband was diagnosed with cancer. Later on she became the primary caregiver for her father, along with her mother who had become critically ill from burnout prior to her dad\u2019s passing. In recent years, she cared for several friends with AIDS while continuing to care for her mother and actively providing support, information, referrals and resources for caregivers.<\/p>\r\n\r\n

Gail's leadership on the Internet and her success with Empowering Caregivers led her to found National Organization For Empowering Caregivers (NOFEC) INC in 2001.<\/p>\r\n\r\n

Prior to founding NOFEC, she created the iVillageHealth Chat: Empowering Caregivers, which she hosted for over 5 years. Within a month of hosting she created Empowering Caregivers: www.care-givers.com in 1999 as a resource for caregivers around the globe. Over three million visitors have frequented the website.<\/p>\r\n\r\n

She has presented at national and international care-related conferences and programs and has been a keynote speaker for many programs as well.<\/p>\r\n\r\n

Ms Mitchell has assisted thousands of caregivers online and offline in ways to empower themselves in their roles in caring for loved ones.<\/p>\r\n\r\n

For a list of clients and\/or her resume, please contact info@care-givers.com<\/a><\/p>\r\n\r\n

Gail's articles have been published in many venues nationally and in Canada. Presently, she is a member of American Society on Aging and National Quality Caregivers Coalition.<\/p>\r\n\r\n

Gail has discovered that there is life after caregiving: She has become a successful ceramic artist and installation\r\n artist. She created Crystal Illumination Art to bring the transformative quality of illumination, light and color to\r\n the human experience and celebrate its ability to inspire, heal and nourish our physical, mental, emotional and\r\n spiritual well being.<\/p>"}],"_links":{"self":[{"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/posts\/625","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/comments?post=625"}],"version-history":[{"count":3,"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/posts\/625\/revisions"}],"predecessor-version":[{"id":5179,"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/posts\/625\/revisions\/5179"}],"wp:attachment":[{"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/media?parent=625"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/categories?post=625"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/tags?post=625"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/care-givers.com\/articles\/wp-json\/wp\/v2\/ppma_author?post=625"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}