Nikita Klein
DOX1122 DOX PWD

74 yrs (16/12/1951)

08105 485371 / 08212 819947

nikita_klein@example.com

NHS Number: 3932687663

Mild cognitive impairment, diagnosed Nov 2024

AA: Applied/applying

Council tax: Exempt

Driving: Awaiting assessment

Blue badge: Does not currently meet threshold

Health & wellbeing LPA: Not got capacity

Property & finance LPA: Declined to apply

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Background

PWD's personal background e.g. who are they, what did they do, what do they enjoy etc.

Dementia Symptoms Experienced

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

Medication

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

Physical Health and Mobility

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

Diet and Nutrition

Care and Support

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

Social Engagement

Also include any volunteer befrienders here

Financial / Legal / Future Planning

Will appear below 'Core Advice' on summary

Notes / Comments

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