2014 aging families worksheet
TRANSCRIPT
Aging Families WorkbookMichael S Gibbons, [email protected]
https://mga.academia.edu/MichaelGibbons
workbook address:https://www.academia.edu/7605271/2014_Aging_Families_Worksheet
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Quick Sheet:
Medical 1:
Medical 2:
Guardianship 1:
Guardianship 2:
Finance 1:
Finance 2:
Social 1:
Social 2:
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Transportation 1:
Transportation 2:
Employment 1:
Employment 2:
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Introduction
Introduction:
This workbook is designed to help you prioritize the most important information someone needs to know about your family member. As the primary caregiver, you carry around a tremendous amount of informationin your head that can be overwhelming to whomever needs that information later on. Putting it all down in a fast and accessible format will make transition easier for all involved.
The structure of this workbook is based on research examining families’ needs. The sections are organized according to families’ reported preferences. Medical information needs were often reported tobe most important, and so the medical section comes first.
There is also a Quick Sheet page designed to be first. This puts the most important and/or most common information on a single easy to findpage. So, the physician or hospital information you want fastest or most frequently can go right on the first page. There is of course much more important medical information, and that will go in the broader medical section.
Each page in each section is organized so that whatever contact information you need is right at the top. There is room in the middlefor specified notes about what it is that page is dedicated to. So if it’s a medical page, in the notes section you can mention when the condition started, what physicians have been seen, and so on. If it’s a finance page, you can talk about investment decisions that were madein the past and how that influenced SSI, and so on.
Each page also has a Red Flags and an Orange Flags section where you can put vital information. If something is going on that needs to get attention immediately it is a red flag and should be mentioned. If something is going on that needs to be watched closely, that is an orange flag.
At the same time, this workbook is only meant to be a guideline, to help you start your individual information archive. As these pages aremeant to be filed in a three ring binder, you can put the sections in whatever order works best for you. You can print and fill out two
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Introduction
Quick Sheets if you want to. The format we have provided here is meantto be easily customizable for your individual situation.
An electronic copy of this workbook, which you can edit yourself, is online at my academia.edu site: http://mga.academia.edu/MichaelGibbons
Thanks, and I hope this helps your family,
Michael S Gibbons, PhD
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Medical/Health
General Practitioner or InternistContact info:
Notes:
ORANGE FLAGS:
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Medical/Health
RED FLAGS:
CardiologistContact info:
Notes:
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Medical/Health
ORANGE FLAGS:
RED FLAGS:
Nutrition Contact info:
Notes:
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Medical/Health
ORANGE FLAGS:
RED FLAGS:
ExerciseContact info:
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Medical/Health
Notes:
ORANGE FLAGS:
RED FLAGS:
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Medical/Health
PsychologistContact info:
Notes:
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Medical/Health
ORANGE FLAGS:
RED FLAGS:
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Medical/Health
Orthopedist / RheumatologistContact info:
Notes:
ORANGE FLAGS:
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Medical/Health
RED FLAGS:
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Guardianship
Current Guardianship Contact info:
Notes:
ORANGE FLAGS:
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Guardianship
RED FLAGS:
Power of AttorneyContact info:
Notes:
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Guardianship
ORANGE FLAGS:
RED FLAGS:
Medical Decision MakingContact info:
Notes:
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Guardianship
ORANGE FLAGS:
RED FLAGS:
Advance DirectiveContact info:
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Guardianship
Notes:
ORANGE FLAGS:
RED FLAGS:
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Guardianship
VotingContact info:
Notes:
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Guardianship
ORANGE FLAGS:
RED FLAGS:
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Finances
SavingsContact info:
Notes:
ORANGE FLAGS:
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Finances
RED FLAGS:
SSI/Other WaiversContact info:
Notes:
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Finances
ORANGE FLAGS:
RED FLAGS:
MedicareContact info:
Notes:
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Finances
ORANGE FLAGS:
RED FLAGS:
Conflicts/Integration IssuesContact info:
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Finances
Notes:
ORANGE FLAGS:
RED FLAGS:
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Finances
IncomeContact info:
Notes:
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Finances
ORANGE FLAGS:
RED FLAGS:
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Finances
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Social
Friends!Contact info:
Notes:
ORANGE FLAGS:
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Social
RED FLAGS:
Down Time ActivitiesContact info:
Notes:
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Social
ORANGE FLAGS:
RED FLAGS:
ChurchContact info:
Notes:
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Social
ORANGE FLAGS:
RED FLAGS:
Sports ActivitiesContact info:
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Social
Notes:
ORANGE FLAGS:
RED FLAGS:
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Social
Dating/RomanticContact info:
Notes:
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Social
ORANGE FLAGS:
RED FLAGS:
Volunteer Contact info:
Notes:
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Social
ORANGE FLAGS:
RED FLAGS:
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Employment
Family Transportation
Contact info:
Notes:
ORANGE FLAGS:
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Employment
RED FLAGS:
Alternative Transportation
Contact info:
Notes:
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Employment
ORANGE FLAGS:
RED FLAGS:
Friends Transportation
Contact info:
Notes:
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Employment
ORANGE FLAGS:
RED FLAGS:
Bus
Contact info:
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Employment
Notes:
ORANGE FLAGS:
RED FLAGS:
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Employment
Cab
Contact info:
Notes:
ORANGE FLAGS:
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Employment
RED FLAGS:
Supervisors
Contact info:
Notes:
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Employment
ORANGE FLAGS:
RED FLAGS:
Coworkers
Contact info:
Notes:
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Employment
ORANGE FLAGS:
RED FLAGS:
Employment Training
Contact info:
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Employment
Notes:
ORANGE FLAGS:
RED FLAGS:
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Employment
Job Coach
Contact info:
Notes:
ORANGE FLAGS:
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Employment
RED FLAGS:
Employment Transportation
Contact info:
Notes:
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Employment
ORANGE FLAGS:
RED FLAGS:
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