All GP information is provided to Sensible Care and is correct as per the client.

Subjective information

(Such as their perception of their memory, whether they have had any episodes of confusion, disorientation, history of headache, dizziness/vertigo, seizures, termors, perception of gait, balance, difficulty in swallowing, difficulty in speaking)

Conscious state - may require assessment with validated tool (Glasgow coma scale)

Subjective information (such as fatigue, ability to undertake activities of daily living, weakness, dyspnoea, coughing, swelling of legs and so on).

(Including activities of daily living)

0 - no further action required

1-3 low risk - if no notable concerns refer to physio if previously not assessed

4-9 high risk falls - risk plan (care managers need to be notified) must be in place, physio referral indicated if not previously attended

Subjective information (Shortness of breath, history of respiratiry infection/allergies, same as for cardiovascular)

Observe:

Breath sounds

CAPS Criteria

Cognition & Behaviour:

The Client has declined the recommendation for the above identified risks. 

*Please see Cognition & Behaviour Section for signature of acknowledgement. 

Smell:

The Client has declined the recommendation for the above identified risks. 

*Please see Smell Section for signature of acknowledgement. 

Taste:

The Client has declined the recommendation for the above identified risks. 

*Please see Taste Section for signature of acknowledgement. 

Hearing:

The Client has declined the recommendation for the above identified risks. 

*Please see Hearing Section for signature of acknowledgement. 

Vision:

The Client has declined the recommendation for the above identified risks. 

*Please see Vision Section for signature of acknowledgement. 

Oral Health:

The Client has declined the recommendation for the above identified risks. 

*Please see Oral Health Section for signature of acknowledgement. 

Nutrition & Hydration:

The Client has declined the recommendation for the above identified risks. 

*Please see the Nutrition & Hydration Section for signature of acknowledgement. 

Food & Fluid:

The Client has declined the recommendation for the above identified risks. 

*Please see the Food & Fluid Section for signature of acknowledgement. 

Medication:

The Client has declined the recommendation for the above identified risks. 

*Please see the Medication Section for signature of acknowledgement. 

Pain:

The Client has declined the recommendation for the above identified risks. 

*Please see the Pain Section for signature of acknowledgement. 

Cardiovascular Systems:

The Client has declined the recommendation for the above identified risks. 

*Please see the Cardiovascular Systems Section for signature of acknowledgement. 

Physical Funcation:

The Client has declined the recommendation for the above identified risks. 

*Please see the Physical Function Section for signature of acknowledgement. 

Respiratory:

The Client has declined the recommendation for the above identified risks. 

*Please see the Respiratory Section for signature of acknowledgement. 

Dietary:

The Client has declined the recommendation for the above identified risks. 

*Please see the Dietary Section for signature of acknowledgement. 

Skin:

The Client has declined the recommendation for the above identified risks. 

*Please see the Skin Section for signature of acknowledgement. 

Endocrine:

The Client has declined the recommendation for the above identified risks. 

*Please see the Endocrine Section for signature of acknowledgement. 

Urinary:

The Client has declined the recommendation for the above identified risks. 

*Please see the Urinary Section for signature of acknowledgement.