GEC REFERRAL CARE MEDICAL RECOMMENDATION/GEC/ID CHILD

GOALS OF CARE:
  Rehabilitation (improved function).
  Skilled nursing care (e.g., manage wounds, medical devices, catheters, 
  ostomy).
  Monitoring/supervision to avoid clinical complications.
  Improve compliance with medications and treatments.
  Patient/Family education.
  Respite (temporary relief for caregiver).
  Palliative/terminal care.
  Reduce hospitalizations and/or ER visits.
  Supportive living/supervision.
  Behavior stabilization.
REFERRING TO WHICH PROGRAM:
  Skilled care in home
  Home Based Primary Care (HBPC)
  ADL assistance (personal care) in home
  Chore services (homemaker) in home
  Adult Day Health Care
  Residential care (supervised living)
  Assisted Living
  Domiciliary care
  Short-term nursing home care (subacute care, rehab)
  Long-term nursing home care
  Outpatient Respite Care
  Inpatient Respite Care
  Specialized Dementia/Geropsych Care
  Inpatient Palliative/Hospice Care (NHCU)
  Outpatient Palliative/Hospice Care (Home)
  All-inclusive care or PACE program
  Home Telehealth
ESTIMATED DURATION OF SERVICES:
  2-3 months
PROGNOSIS:
    In the last 7 days, the patient HAS NOT experienced a flare-up of a 
    recurrent or chronic health problem.
    The direct care staff (MD, RN, Rehabilitation) thinks the patient IS 
    capable of increased independence (in ADL's, IADL's, or mobility).
    The patient DOES NOT HAVE a limited life expectancy (likely to be less than 
    6 months).
WEIGHT BEARING STATUS:
  Patient is partial weight-bearing.
DIET:
  The patient is on a regular diet.
EQUIPMENT NEEDED:
  Hospital bed
  Special mattress
  Trapeze
  Walker
  Cane
  Wheelchair
  ADL equipment
  Orthotic or splint
  Other equipment:
    prostesis
SUPPLIES NEEDED:
  Catheters
  Tubing
  Dressings
  Wrappings
  Tape
  Glucose Strips
  Ostomy Supplies
  Saline
  Other Supplies:
    s
Other Comments:



Consult to Geriatrics/Extended Care ordered.