Descriptive Name

Personal Health Communication, Transfer of Care, Coordination of Care.

see Use Case Actors

This 77 year old fenmale resident of a CCRC has been managing well at an assisted living level of care until approximately one month ago. Although she has had some difficulty walking and has used a walker with front wheels for some time it is apparent that at this time she may not be able to continue to ambulate independently. She has "stumbled" and almsot fallen three times in the past month. In addition she has had some memory deficts for at least two years but more recently she has become confused and has tried to enter the wrong room and has failed to appear at meal time. It has also been noted tnat she appears to have "wet" herself on a nnhumber of occasions but she has denied this when questioned. She is being assessed for nursing home level care at this time.