THE IDEAL TOOL STEP 1: IDentify needs PATIENT NAME: IDentify the patient’s specific needs or areas of concern Start by specifying the patient’s needs and any reasons for concern. Consider: Personal decision-making ☐ Making decisions ☐ Communicating decisions ☐ Carrying out decisions (with or without assistance)
Community services and supports ☐ Case management ☐ In-home care ☐ Transportation assistance ☐ Home or vehicle modifications ☐ Durable medical equipment or assistive technology ☐ Residential services ☐ Behavioral support services ☐ Family caregiver training, support, respite care ☐ Other (specify):
Medical treatment and discharge planning ☐ Informed consent for medical treatment (including end-of-life care) ☐ Following a treatment plan ☐ Safe discharge or transfer Mental health/psychiatric treatment ☐ Consent to treatment (including medication management) ☐ Admission to mental health facility ☐ Psychiatric bed Managing assets or benefits ☐ Access to financial and other records ☐ Applying for benefits ☐ Spend down options (for benefit eligibility) ☐ Paying bills or managing incom e
Other issues/concerns ☐ Patient/family conflict ☐ Abuse, neglect, or exploitation ☐ Other (specify):
Observations & notes:
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