Elder Care Forms

 

Preparing For Care

As you may know, providing care for a senior loved one requires many talents and abilities. Add to these assets the patience to fill out paperwork and the foresight to prepare for future needs.

Below is information on the most useful and asked for forms/documents that are required for our clients to meet their loved one's care needs and preferences.

  • Physicians Report - This form must be filled out before moving to an assisted living or residential care home. It must be completed by the primary care physician of the senior in need of care. It's main purpose is to help determine the care needs, diagnosis, and medical history of the senior. A recent TB test (can take a week) or a chest X-ray to show negative results for TB will also be required. For more information, go to Dept. of Social Services.
  • Physician Orders for Life-Sustaining Treatment (POLST) - This form outlines a plan of care reflecting the patient’s wishes concerning care at end of life. It is printed on bright pink paper, and signed by both a doctor and patient. And it complements an Advance Healthcare Directive. For more information, go to POLST California.
  • Advance Health Care Directive (AHCD) - Lets a person's physician, family and friends know their health care preferences. These can include the types of special treatment they want or don't want at the end of life, along with their desires for diagnostic testing, surgical procedures, cardiopulmonary resuscitation and organ donation. Also provides a person/agent with Power of Attorney for Health Care. For more information, go to Office of Attorney General (CA).

Physician's Report

Required prior to admission to an assisted living or residential care home. It must be completed by the primary care physician of the senior in need of care.

POLST Form

Physicians Orders for Life Sustaining Treatment form specifies the types of medical treatment that a seriously ill patient wishes to receive.

Advance Health Care Directive (AHCD)

This directive lets physician, family and friends know the health care preferences of your senior loved one.