Aged Care Assessment

UnitID 1 1
Date 2001/5/14 2001/5/14
Started 12:16 12:40
Finished 12:39 13:03
Client Details
Surname Baxter  Trent 
GivenName June  George 
Gender Female  Male 
DateofBirth 12-9-19  16-7-17 
Address 5 Lyons St, Cannington, Perth, WA  7 Archer Way, Mandurah, WA 
PhoneContact (08) 9632074  (08) 96543298 
MaritalStatus Widowed  Married 
LiveWith Alone  Spouse 
Accomodation Unit, Owner,  Retirement Village, Owner, 
PreferredLanguage English  English 
AssessmentLocation At Home  At Home 
Assessor Mary Lang  Janice Harper 
Medical History
DrGP Dr Alan Miller  Dr Lyn Miller 
DrContact (08) 57893424  (08) 67853246 
Diagnosis Osteoarthritis in hips and knees. Diabetes.  Right below-knee amputee. Diabetes. Cataract. 
Disability Muscle Weakness and Pain.  Reduced mobility, blurred vision, confusion 
Medication Analgesics  Insulin. Celebrex. 
Disorientated No  Yes 
Wandering No  No 
DisruptiveBehaviour No  No 
HearingImpairment Yes  Yes 
SightImpairment Yes  Yes 
SpeechImpairment No  No 
PerceptualImpairment No  No 
CognitiveImpairment No  Yes 
Incontinent No  No 
Other   Confusion and memory loss  
Personal Care
Eating Independent,  Independent, 
Dressing Independent,  Needs Assistance, 
Grooming Independent,  Needs Assistance,Assisitive Devices, 
Bathing Independent,Assistive Devices,  Needs Assistance,Assistive Devices, 
Toileting Independent,Assistive Devices,  Needs Assistance,Assistive Devices, 
BladderBowel Independent,  Independent, 
TakeMedication Independent  Needs Assistance 
Chair Independent,  Needs Assistance,Assistive Devices, 
Bed Independent  Assistive Devices 
BathShower Independent,Assistive Devices,  Needs Assistance,Assistive Devices, 
Toilet Independent,Assistive Devices,  Needs Assistance,Assistive Devices, 
Mobility Independent,Assistive devices,  Needs assistance, 
MobilityAids Walking Stick,  Crutches, 
MealPreparation Independent,  Needs Assistance, 
FollowSpecialDietifnecessary Independent,  Needs Assistance, 
Shopping Needs Assistance,  Dependent, 
Laundry Needs Assistance,  Dependent, 
LightHousework Needs Assistance,  Needs Assistance, 
HomeMaintenance Needs Assistance,  Dependent, 
UseTelephone Independent,  Needs Assistance, 
PublicTransport Needs Assistance  Dependent 
UsePrivateTransport Needs Assistance,  Needs Assistance, 
ManageFinances Independent  Needs Assistance 
HomeModification No  No 
Home Safety
Layout Safe  Unsafe 
FloorSurfaces Unsafe  Unsafe 
StepsStairs Unsafe  Unsafe 
Security Safe  Unsafe 
Heaters Safe  Unsafe 
SmokeDetector Safe  Unsafe 
Emergency Safe  Unsafe 
Care Services
Carer Yes  Yes 
Caregiver Family,  Family, 
PrimaryCaregiver Provide care to others  Have poor health 
TypeofCare Community,Flexible,Low Level,  Residential,Low Level, 
Residential Respite,  Hostel, 
Community Care Package,Home Help,   
TypeofFlexibleCare Domestic and occasional respite    
AlliedHealthSupport Occupational Therapy  Physiotherapy