CAREGIVER NOTBOOK
Client Name
First Name
Last Name
Initial Plan
Care Plan
Need
Bathe (tub/shower/bed/sponge)
Shave
Shampoo Hair
Brush/Comb Hair
Skin Care (lotion)
Prepare Meal/Snack
Feed Client
Fluids
Medication Reminder
Assist with Walking
Assist with Transfers
Assist with Exercise
Clean Living Areas/Pathways Clear
Clean Floors (sweep/mop/vacuum)
Clean Kitchen/Wash Dishes
Clean Bathroom
Empty Garbage
Make Bed/Change Bed Linens
Wash Clothes/Bed Linens
Errands/Shopping/Transportation
Assist with Clothing/Dressing
Oral Care (brush teeth/dentures)
Foot Care/Foot Soaks
Assist with Toileting / Incontinence Products
Care Plan
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Bathe (tub/shower/bed/sponge)
Shave
Shampoo Hair
Brush/Comb Hair
Skin Care (lotion)
Prepare Meal/Snack
Feed Client
Fluids
Medication Reminder
Assist with Walking
Assist with Transfers
Assist with Exercise
Clean Living Areas/Pathways Clear
Clean Floors (sweep/mop/vacuum)
Clean Kitchen/Wash Dishes
Clean Bathroom
Empty Garbage
Make Bed/Change Bed Linens
Wash Clothes/Bed Linens
Errands/Shopping/Transportation
Assist with Clothing/Dressing
Oral Care (brush teeth/dentures)
Foot Care/Foot Soaks
Assist with Toileting / Incontinence Products
Toileting - Bladder
Toileting - Bowel
Bathing
Personal Care
Dressing Assistance
Oral Care
Shaving Care
Exercise
Fall Risk
Watch for Hazards
Watch Food Intake
Transportation
Meal Prep
Medication Reminders
Height
Weight
Number
Client Assessment
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