Scenario Urgent referral from care home to hospital 2.16.840.1.113883.3.1937.777.28.3.23

A description of what is most important to you

Emergency Information

Include any essential information that any professional in health and social care should know about the you in any situation, including emergencies.

Other Information

  This could include:

•   Values

•   Spirituality/religion

•   Ethnicity

•   Culture

•   Pets

•   Goals and aspirations

•  Meaningful activities including leisure activities, visiting places, sport and exercise, listening to music, employment, education, volunteering

Details of who is important to you and why. They could be family members, carers, friends, members of staff etc .

Include how you want the people important to you to be engaged and involved in your care and support in both emergency and normal situations.

Who should not be contacted or consulted about your care and support and why, if you wish to say

A description of how you communicate normally including any communication aids you use, for example a hearing aid.

• Include your preferred language of communication, if your first language is not English.
• Include how you would communicate when you are in pain or distress.
• Include how you communicate choices.
• Include how you give feedback or raise a concern.

Describe how you would like others to engage and communicate with you , including how you would like to be addressed.

A description of things you want someone supporting you to do or not to do.

For example, this might include:

• Talk to me not to my carer
• Remind me to take my medication
• Encourage me to wash my hands regularly
• Explain to me what is happening and why
• Respond to my communication

 A description of things you do not want someone supporting for you to do. For example, this might include:

• Asking questions about certain topics
• Making assumptions about something
• Providing support when it is not wanted
• Talking to you in a certain way

A description covering what you are able to do, how you engage with others and how you feel on a typical day through to on a day when you are unwell.

• Include any causes that might result in you becoming unwell and strategies for avoiding or addressing the causes. For example, not drinking enough water could cause constipation.
• Include any signs that indicate you might be becoming unwell.
• On a bad day describe what is different about what you are able to do, how you engage with others and how you feel.
• Include any medical conditions e.g. dementia and any symptoms e.g. itchiness, cough, pain that you are living with and that that affect your everyday life and how you manage those conditions.
• Include past health issues or experiences that need to be considered

A description of how and when you want someone caring for you to support you.

This could include support needs in an emergency situation (for example taking blood)

This could include support you need to maintain important routines or to carry out particular activities, for example:

• Personal care routines
• Eating and drinking
• Bedtime routines
• Taking medications
• Moving and transitioning

 This could also include support needed with:

• wearing glasses/hearing aids/false teeth etc.
• making informed choices or understanding dangers and risks.
• managing your emotions, moods and behaviours.
• memory or confusion.

Include how your support needs change in different environments.

Include any triggers that might result in you needing further support and strategies for avoiding or addressing the triggers.

Include how you want the support to be provided.

A description of what is also worth knowing about you for people caring or supporting you.

This could include a short history of your life (where you have worked, where you lived, important events in your life, important people in your past life).

This could include a short profile of your current life:

• your work / study
• your aspirations
• your skills
• your networks
• things you like e.g. particular foods, places, a football team and things you like to talk about.
• things you dislike

 This could also include any care and support preferences that have not been included elsewhere.