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Caregiver Daily Instructions-Page 2

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Caregiver Daily Instructions-Page 1
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Caregiver Daily Instructions-Page 3
Instructions-Appointment Schedule
Instructions-Daily Hygiene Schedule
Instructions-Daily Meal & Snack Schedule
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Index Page

SPECIAL PLACES

 

Favorite Setting

Is there a favorite spot in the house they would prefer being in during different times of the day?  A special chair?  Are there areas that should be avoided?  Why?

 

Mornings:

Afternoon

Evenings:

Nap time:

Bedtime:

Meals:

Other

 

Favorite Places/Places they like to go

Do they like to take a walk daily?  Have coffee with a neighbor? Go to the movies?  Indicate where the caretaker may take them in your absence.

 

 

 

Entertainment Preferred

Describe what they enjoy doing the most in their daily routine.  Do they like having a book or newspaper read to them?  Listen to a favorite tape, radio or TV station?  Are there games they enjoy playing alone or with someone?

 

 

Recreation

Are there daily or weekly schedules of outings?  Do they enjoy being taken to a nearby park? Will someone be taking them to a movie, etc..

 

 

Habits & Hygiene

 

Personal Habits

Describe any personal traits the caretaker should be aware of: for example if the person hates bathing, changing clothes, changes clothes frequently, or has any compulsive tendencies

 

 

 

Grooming (see Daily Schedules below)

Indicate how much assistance is required and normal daily schedule for each.

 

Dental Care

Bathing

Shaving

Hair Care

Toileting

Personal Care

Dressing

Other/Additional Details

 

Cleanliness and Neatness

Indicate personal habits, areas of difficulty, special needs for protective clothing etc.

 

 

Bathroom

Describe any special needs that should be considered.  What is their level of urgency, i.e. should they be taken immediately to a restroom when they indicate they need to relieve themselves?  Are they incontinent?  If yes, what special things need to be considered?

 

 

 

Bathing

Do they need assistance?  Prefer shower or tub?  Any special equipment, like a tub chair required?  Do they have any preference for soaps or shampoos?  Do they like to linger or get it over with quickly?  What is their level of modesty, what might embarrass them?

 

-> Caregiver Daily Instructions-Page 3