The Family Assessment Form and the Behavior Profile are guides designed to assist you in determining the level of need for your loved one.
The Family Assessment Form and the Behavior Profile are guides designed to assist you in determining the level of need for your loved one.
After you have completed these forms, feel free to send via mail or fax to the attention of Chris Braley, Braley Care Home’s licensed clinical social worker. He will be happy to discuss the results of the assessment tools and any other concerns you may have. The Pre-Admission Resident Assessment Form is required for admission to Braley Care Homes. It must be filled out by the resident’s physician within 60 days prior to the date of admission to the facility.
Learn more about the Stages of Dementia and how Braley Care Homes can help. Braley Care Homes use the Global Deterioration Scale, which has seven stages. The three stages below are a condensed version.
Mild
Denial is dominant defense mechanism
Reads a passage or a book and retains relatively little material
Blame others for stealing lost items
Repeat themselves
Arrives at wrong time or place
Forgets why they went to the store
Has multiple late notices for bills
Lost interest in hobbies or activities
Unwilling to try new things
Easily taken advantage of, such as giving large sums of money to strangers
Mild
Denial is dominant defense mechanism
Reads a passage or a book and retains relatively little material
Blame others for stealing lost items
Repeat themselves
Arrives at wrong time or place
Forgets why they went to the store
Has multiple late notices for bills
Lost interest in hobbies or activities
Unwilling to try new things
Easily taken advantage of, such as giving large sums of money to strangers
Moderate
Five minutes or less of functional short-term memory
Becomes lost if away from familiar surrounding
Wander around streets, perhaps at night, sometimes becoming lost
Neglectful of hygiene and/or eating
Forget names of family or friends, or confuse one family member with another
See or hear things that are not there
Forgetfulness is creating unsafe environment, such as leaving gas unlit or food on a stove
Can’t remember visits even though the visitor just left
Can’t follow written signs, write name, add or subtract
Severe
Lose ability to understand or use speech
Incontinent
Little or no recognition of friends or family
Needs assistance with eating, washing, bathing, toilet and dressing
Aggressive tendencies, such as attempting to hit the person next to them
Requires assistance walking, or confined to a wheelchair
Looks in mirror and talks to own image or becomes afraid
Learn more about the Stages of Dementia and how Braley Care Homes can help. Braley Care Homes use the Global Deterioration Scale, which has seven stages. The three stages below are a condensed version.
Mild
Denial is dominant defense mechanism
Reads a passage or a book and retains relatively little material
Blame others for stealing lost items
Repeat themselves
Arrives at wrong time or place
Forgets why they went to the store
Has multiple late notices for bills
Lost interest in hobbies or activities
Unwilling to try new things
Easily taken advantage of, such as giving large sums of money to strangers
Moderate
Five minutes or less of functional short-term memory
Becomes lost if away from familiar surrounding
Wander around streets, perhaps at night, sometimes becoming lost
Neglectful of hygiene and/or eating
Forget names of family or friends, or confuse one family member with another
See or hear things that are not there
Forgetfulness is creating unsafe environment, such as leaving gas unlit or food on a stove
Can’t remember visits even though the visitor just left
Can’t follow written signs, write name, add or subtract
Severe
Lose ability to understand or use speech
Incontinent
Little or no recognition of friends or family
Needs assistance with eating, washing, bathing, toilet and dressing
Aggressive tendencies, such as attempting to hit the person next to them
Requires assistance walking, or confined to a wheelchair
Looks in mirror and talks to own image or becomes afraid
CONTACT US
Location:
Braley Care Homes
6192 US 60
Hurricane, WV 25526
Phone Numbers:
Referrals and Inquiries: (304) 767-4033
Facility Phone: (304) 201-3677
Facility Fax: (304) 201-3678
AREAS WE SERVE
BUSINESS HOURS
Monday
9:00am – 6:30pm
Tuesday
9:00am – 6:30pm
Wednesday
9:00am – 6:30pm
Thursday
9:00am – 6:30pm
Friday
9:00am – 6:30pm
Our clinic largest private mental health partnership, with a carefully selected nationwide team of Psychiatrists.
KEEP IN TOUCH.
CONTACT US
Location:
Braley Care Homes
6192 US 60
Hurricane, WV 25526
Phone Numbers:
Referrals and Inquiries: (304) 767-4033
Facility Phone: (304) 201-3677
Facility Fax: (304) 201-3678
AREAS WE SERVE
BUSINESS HOURS
Monday
9:00am – 6:30pm
Tuesday
9:00am – 6:30pm
Wednesday
9:00am – 6:30pm
Thursday
9:00am – 6:30pm
Friday
9:00am – 6:30pm