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Care Home Risk Assessment Example  Form

Care Home Risk Assessment Example Form

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Months) Orthostatic Changes 0 1 1 1 1 1 1 0 2 4 G. Medications ------ Patient Status/Condition Alert and oriented X3 Disoriented X 3 at all times Intermittent confusion No falls 1-2 falls 3 or more falls Ambulatory & continent Chair bound & requires assist w/ toileting Ambulatory & incontinent Adequate (w/ or w/o glasses) Poor (w/ or w/o glasses) Legally blind Have patient stand on both feet w/o any type of assist then have walk: forward, thru a doorway, then make a turn. (Mark all that...
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