Free template

Dementia assessment template and care support plan

Our comprehensive Dementia Assessment Template and Care Support Plan is designed to help caregivers provide personalized and holistic care for individuals with dementia. This template facilitates a thorough understanding of the individual’s needs, preferences, and personal history to ensure their well-being and comfort.

Key Sections:

  • Personal Information: Capture essential details like name, address, and preferred name.
  • Communication Needs: Document communication difficulties and strategies to assist.
  • Personal History: Record past occupations, hobbies, values, and cultural background.
  • Cognitive Needs: Assess the impact of dementia on thinking and memory.
  • Safety Concerns: Identify safety issues and necessary support measures.
  • Anxieties and Fears: Understand current anxieties and how to alleviate them.
  • Family and Social Connections: Maintain important relationships and social activities.
  • Financial and Environmental Needs: Address financial issues and environmental interactions.
  • Signs, Symptoms, and Medication: Track symptoms and manage medications.
  • Personal Care Needs: Detail hygiene, dietary preferences, and personal care requirements.
  • Social and End-of-Life Care: Plan for social activities and end-of-life arrangements.

Dementia Assessment Template and Care Support Plan