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AA: Advised to apply
Council tax: Not discussed
Driving: Not driving
Blue badge: Advised to apply
Health & wellbeing LPA: In place
Property & finance LPA: In place
Number Completed at
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PWD's personal background e.g. who are they, what did they do, what do they enjoy etc.

What effect is dementia having on their memory and behaviours? Are they aware of the diagnosis (insight)?

What dementia medication are they taking? How are they finding it? Who assists? Do they have a blister pack?

How physically healthy / mobile are they? Any falls? Any sensory impairment? Any assistive/preventative tech in place? Personal care?

Referred to Maggies Oxford

Will appear below list of carers. How are they coping? Is the support fit for purpose?

Also include any volunteer befrienders here

Will appear below 'Core Advice' on summary

Anything else to include on the case summary