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FIRST NAME

Adele

LAST NAME

Hall

Assessment Completed

CLIENT PROFILE

PROGRAMME DETAILS

CLIENT PROFILE

PROGRAMME DETAILS

ASSESSMENT FORMS

ASSESSMENT FORMS

Anchor 1

Contact Details

DATE OF BIRTH:

Mar 6, 1965

PHONE:

07960 021728

EMAIL:

ADDRESS:

2

Kathian Close

Rochdale

OL16 5BZ

Referral Details

ORGANISATION:

Alzheimer's society

CONTACT:

Julie Mann

Client Notes

Needs Of The Client (From referral)

Adele is the main carer for her father bill who has advancing dementia. She also cares for her mother who is extremely frail and she is the main carer for her partner who has a number of very serious conditions. I think Adele may have been through your service before but not by myself as she has only recently become known to me. Adele was extremely stressed and tearful during my meeting with her as she is worried about the future long term care of her father. She would benefit from relaxation and possibly counselling.
Adele is he cousin of Rachel Chambers from the CCG- it was Rachael who referred her to me.
She would benefit from treatment at your earliest convenience.

Additional Notes (From KWH)

Availability Information

Yes

No

Does the client need to start services immediately?

Therapy Details

Does the client require holistic therapies?

Yes

No

Counselling Details

Yes

No

Does the client require counselling services?

WARNING!

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I'M SURE

STATEMENT

No

Well-being Assessment Form

Client has Dementia -

SWEMWBS

STATEMENT

No

NONE OF THE TIME

SOME OF THE TIME 

ALL OF THE TIME 

RARELY

OFTEN

1.

I've been feeling optimistic about the future

2.

I've been feeling useful

3.

I've been feeling relaxed

4

I've been dealing with problems well

5

I've been thinking clearly

6

I've been feeling close to other people

7

I've been able to make up my own mind about things

INITIAL SCORE:

40

WELL-BEING INDICATOR:

ABOVE AVERAGE

Well-being scale:

0 - 21 = Low   |   22- 24 = Below Average   |   25 - 26 =  Average   |   27 - 35 = Excellent

Short version of the "Warwick-Edinburgh Mental Well-being Scale" (SWEMWBS) @NHS Scotland, University of Warwick and University of Edinburgh 2006 all rights reserved

ONSSWQ

NOT AT ALL

EXTREMELY 

1

How satisfied are you with your life nowadays?

2

How happy did you feel yesterday?

3

How anxious did you feel yesterday?

4

Do you feel that the things you do are worthwhile?

The Office of National Statistics' subjective well-being questions (ONSSWQ). All rights reserved

SOCIAL TRUST

MOST PEOPLE

CAN BE TRUSTED

CAN'T BE

TOO CAREFUL

No

STATEMENT

1

Would you say that people can be trusted?

The New Economic Foundation's social trust question (NEFST). All rights reserved

KWWBS

STATEMENT

No

DISAGREE

AGREE

1

Overall, I have a great sleep: pattern

2

I, mostly, have a great range of motion:

3

Most of the time, I don't feel tense 

4

Generally, I don't feel physically drained

Developed at Kenny Webber by adapting established principles and techniques from research into the physical aspects of mental health.

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