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Care Plan Review

Lillian Gordon

Effective Date: April 22, 2026

Lillian lives in senior housing and is able to make decisions about her own care. Her daughter-in-law is her main caregiver, and her family is very supportive. Help includes cooking meals, keeping her home clean, assisting with personal hygiene, dressing, and bathing. She gets reminders to take her medications and is given rides to appointments or errands when needed. Grocery shopping and errands are done based on what Lillian wants. Everything is done with her guidance, and any changes or concerns are shared with her son, her POA or the agency.

Lillian is currently experiencing an exacerbation of her venous disease. She is wearing compression stockings and keeping her related medical appointments. Caregiver should remind her to perform her prescribed exercises daily. Lillian states that she tries to do as much as she can for herself. Level of care remains unchanged and appropriate. Lillian continues to benefit from proximity and consistent caregiver support. She is overall satisfied with her services, and current hours remain appropriate. There have been no falls or incidents reported in the past 6 months.

Care Schedule

Saturday โ€“ Friday
9:00 AM โ€“ 5:00 PM

Task Codes & Instructions

Full Assistance
Hands-On Assistance
Standby Assistance
Support / Reminders
Code Task Level of Care Instructions Frequency
115 Meal Planning & Preparation Full Assistance Full assistance with meal planning and preparation as needed. Prepare breakfast, lunch, and dinner. Daily
116 Housework / Chores Full Assistance Full assistance with keeping home clean and organized as needed. Daily
118 Managing Medications Reminders Only Provide reminders for medication schedule. Medications are pre-organized in daily med boxes. Daily
119 Shopping Support Support with grocery shopping and errands as needed based on client preferences. As Needed
120 Transportation Support Provide transportation to appointments and errands as needed. As Needed
122 Hygiene Hands-On Hands-on assistance with personal hygiene as needed. Daily
123 Dressing Upper Hands-On Hands-on assistance with upper body dressing as needed. Mon โ€“ Fri
124 Dressing Lower Hands-On Hands-on assistance with lower body dressing as needed. Daily
129 Eating Support Verbal coaching and cueing during meals as needed. Every Shift
132 Personal Care Standby/Hands-On Caregiver available to provide standby or hands-on assistance as needed. Daily
134 Bathing Standby/Hands-On Standby or hands-on assistance with bathing as needed. Daily

Ongoing Acknowledgements

Complete this section each time the care plan is reviewed or updated.

Name Initial Date Reviewed Changes / Notes