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Dementia Care Plan Template
Basic Information
Patient Name: [Your Husband’s Name]
Caregiver Name: [Your Name]
Date Created: [Insert Date]
1. Medical Care
• Primary Physician: [Name & Contact Info]
• Neurologist/Geriatrician: [If applicable]
• Medications: [List medications and schedules]
• Appointments: [Keep a calendar of upcoming visits]
• Monitoring: Track changes in memory, mood, appetite, sleep, mobility
2. Daily Routine & Structure
• Morning Routine: Wake-up time, hygiene, breakfast
• Daytime Activities: Light exercise, music, puzzles, walks, supervised outings
• Evening Routine: Dinner, quiet activities, bedtime rituals
• Consistency is key: Try to maintain familiar schedules and settings
3. Safety Measures
• Home assessment completed: [Yes/No]
• Remove fall risks (rugs, cords, clutter)
• Use night lights in hallways and bathrooms
• Lock medications and cleaning products
• Consider ID bracelet or GPS tracker for wandering risk
4. Communication Strategies
• Use simple, calm language
• Speak slowly and face-to-face
• Use visual cues and gentle touch when needed
• Avoid arguing; redirect instead
• Allow extra time for responses
5. Personal Care Needs
• Bathing/Grooming: [Assistance level needed]
• Toileting: [Incontinent products? Schedule?]
• Nutrition: [Favorite meals, mealtime schedule, supervision]
• Mobility: [Assistive devices? Fall precautions?]
• Sleep: [Monitor patterns, reduce stimulation before bed]
6. Emotional & Social Support
• Engage in reminiscence or meaningful conversations
• Involve in simple household tasks
• Allow time outdoors or with pets
• Provide reassurance during moments of confusion or agitation
• Keep family/friends involved with visits or calls
7. Caregiver Support
• Join a dementia caregiver support group
• Schedule respite care regularly (family, home health, adult day programs)
• Practice self-care: rest, eat well, see your own doctor
• Use resources like the Alzheimer’s Association, Area Agency on Aging, or local home care services
8. Emergency Plan
• Keep emergency contacts visible
• Document medical history and medication list
• Establish a plan for sudden changes or behavioral crises
• Consider advance directives or healthcare power of attorney
Helpful Answer (0)
Reply to BettieVicencio
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Consult with / concern:

1. An independent medical social worker. Ask what they offer.

2. Discuss with your wife's MD / medical team, which may include a social worker.

3. Much depends on if you want to place your spouse in a facility for - more care than you can provide - or 24/7. If you want to keep her at home, you will be paying up to / around $10K+- a month for caregiver services ... and you supervising, finding replacements when they do not show up (if independent).

4. Likely, different organizations / departments in differing states have different service offerings, unless federal or state mandated... although federal 'help' now is either non-existent or very tentative ... or changing daily.

Gena / Touch Matters
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Reply to TouchMatters
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The previous 3 responders gave very good examples of what nurses and aids call a care plan. What you may find useful is to consider that events would cause you to make changes to the current set up. If you do not currently have aides coming to the house, what events would have you bring someone in? Difficulty getting your spouse to shower? His refusal or inability to get out of bed? A short-term (or long-term) illness or debility of your own? What conditions would cause to to believe placement is the safest option for you both? This kind of planning helped me navigate levels of care and resuscitation status for my mother with a clear mind and conscience. Best wishes
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Reply to MaryNTN
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If in the home list activities/meals and meds for the day.
Helpful Answer (1)
Reply to brandee
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Care plans are usually done by RNs in facilities. If your in your own home, why do you feel you need a care plan? Do you have aides coming in to help with husbands care?

Here's what I found for in home careplan:

An in-home care plan is a personalized document outlining the specific care needs, goals, and preferences of an individual receiving care at home. It serves as a roadmap for providing high-quality, tailored care and is often developed collaboratively with the individual, family, and healthcare providers. 

Here's a more detailed look at what's typically included in an in-home care plan:

Key Components:
Medical Information:
Detailed medical history, current diagnoses, treatments, medications, and allergies. 
Goals:
Long-term and short-term goals for the individual's care, including desired health outcomes and improvements in quality of life. 
Caregiver Team:
A list of medical and non-medical caregivers, their contact information, and availability. 
Responsibilities:
A clear outline of which caregiver is responsible for specific aspects of care (medical, functional, emotional, social). 
Schedule and Routine:
A daily, weekly, and monthly care schedule that incorporates both medical needs and personal preferences. 
Emergency Plans:
Procedures for ensuring patient safety and emergency contact information. 
Legal and Financial Factors:
Documentation to ensure compliance with the individual's rights and wishes, such as advanced directives. 
Helpful Answer (3)
Reply to JoAnn29
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Is your spouse in care?
If so, then the care plan is made by the facility.
The care plan is a simple form that travels with all different caregivers in a facility, to give them a quick eyeball on the needs and idiosyncracies of their clients.

If you are living at home with hubby I am uncertain what you mean by "care plan".
If it is of comfort to you to have a sort of diary in which you make a "plan" such as:
7:00 Up. Breakfast. Give Atenolol.
8:00 Shower.
9:00 Walk in the park or gentle exercising, weather dependent
That sort of thing......................then go ahead. But normally, when you are caring for someone in a home situation, things needn't be "spelled out" and are more adaptable to circumstances.

The purpose of a care plan is to tell the aids and RNs in care resident that they need their pills crushed and like chocolate pudding in them. That Metamucil should be held if more than 2 stools happen in one day. That resident hates cottage meetings. Etc Etc Etc. Snack at 9 p.m. That sort of thing.

If I am missing something in your question let me know. I will check back in.
Helpful Answer (3)
Reply to AlvaDeer
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