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Jack Smith 1/24/1926
Clinical Assessment

Loma Linda Hospital

Clinical Assessment

Jack Smith 05272013 Mayra Wilson 05272013

Jack Smith 555220
01/24/1926
5/27/13
Jack is a 87-year old widowed male, who was diagnosed with Alzheimer's disease 7 years ago, Jack can not
remember dates or details. Client is not allowed to to drive anymore but sometimes he sheaks out and drive the
car. He lives alone in his family home. He gets frustrated and get aggravated when he cant find things and he
goes on to tearing things out of the drawers. Due to lack of transportation he can only attend the senior activities
at the community church once every other week. Client also forgets to take his medicines or he forgets that he
already took them. Jacks family gave him a small dog which seems to help him with his attitude and he seem to
remember things related to her care.
Local Community Church
Widower, has a son, daughter in law and grandchildren who lives 15 minutes away.
Lonely, only attends the local community once every 2 weeks, he now has the company of his dog name rosie.
Son, daughter in law and grandkids.
Jack Smith 555220 Son
X
05/27/2013
Mayra Wilson

He can still live at home but

with a caretaker for the night
hours, during the day he can
attend an adult day care
He seems to be able to drive
the car even though he should
not. Keys or car need to be
remove from his access
In home Supportive
Services
555--555-5555
n/a
N/A

He has a car but he cannot

longer drive
Maybe the caretaker can drive
him if that is not an option then
we can look at the Access
Services
Access Services
323-780-9777

make sure that he takes his

medication on time and as
prescribed
He will benefit from an Adult
day care where he not only will
socialize but else his medication
will be provided
Loma Linda Adult
day Care
909 558-4000
Jack Smith 555220
1333 Reche Canyon Road
909-5555555
05/27/2013
Loma Linda University East Campus



Getting help with medication, recreation, and meals while maintaining his independence. The client does not interact with people often and this will debilitate his cognitive ability. He has alzheimer's and need help remembering when to take his medications.



Getting help with medication, recreation, and meals while maintaining his independence. The client does not interact with people
often and this will debilitate his cognitive ability. He has alzheimer's and need help remembering when to take his medications.
6/27/2013
Mayra Wilson
Jack Smith 555220
Access Services 323-780-9777
Loma Linda Adult Health service 909-558-4000
In Home Supportive Services 555-555-5555