SAMPLE AFH NEGOTIATED CARE PLAN - Wa

Consent Physical Enablers: Does the resident use any assistive devices such as bedrails, trapeze, transfer pole, walker, wheelchair, etc.? CARE AND SERVICES RESIDENT STRENGTHS/WHAT RESIDENT PREFERS TO DO INDEPENDENTLY WHAT PROVIDER/CAREGIVER/SUPPORT PERSON DOES/WHEN & HOW PSYCH/SOCIAL/COGNITIVE STATUS Yes No What resident does. Describe … ................
................