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CURRENT RESEARCH IN A PREVENTATIVE  MEDICAL CLINIC

HOLISTIC CARE OF THE  ELDERLY/HEALTH SCREENING PROGRAM DEVISED
BY
DR. B.K.PATNAIK

Date of Examination..................

Name……………………………

Age ……                                              M/W/S..............

Accompanied By...........................      Relationship.............................

LIFE STYLE

Daily Living  Activities Mental Agility Support  Required QOL Affected by
  • Independent
  • Supervision required
  • Some help required
  • Totally dependent
  • Clear and confident
  • Forgetful
  • Confused
  • Wandering
  • NIL
  • Family
  • Neighbours and friends
  • Helper
  • Eyes
  • Ears
  • Mouth
  • Feet
HEALTH MATTERS
FACTORS COMMENTS NOTES
Diet: Satisfactory / Unsatisfactory
Exercise: Adequate / Poor
Sleep: Good / Poor
Habits: Tobacco / Alcohol / Stimulants
Hobbies: Yes / No
Extended work skills: Yes / No
MEDICAL MATTERS
DIAGNOSIS PRESENT MEDICATION DOSAGE
                      

     

PREVIOUS INVESTIGATIONS

Blood pressure

Urine / Stool
Routine blood
ECG
X - ray
Others:
COMPLEMENTARY THERAPIES

Homeopathy
Ayurvedic
Naturopathy
Acu - pressure / Puncture
Worship / Meditation
Yoga
CLINICAL EXAMINATION - UNCOVERING MULTIPLE  AND INTER - RELATED ILLNESS average 6-8 conditions
 
  1. Extensive case history.
  2. Comprehensive and systematic physical examination.
  3. Problem oriented documentation.

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