Rolling Acres Care Center RESIDENT NAME: ___JANE DOE___________________________________ ROOM # ___210____ RESIDENT # ____12345________________ THERAPEUTIC RECREATION - RESIDENT INITIAL ASSESSMENT Evaluation: Background Information: Mrs. Jane Doe is an 87-year-old woman. Her admission date is 4/15/2016. She was born in Avoca, Iowa on September 14th, 1928. Doe took some college courses when she was younger, but did not receive a degree. She worked as a sales clerk at Beno’s Deparment Store in downtown Council Bluffs. Her husband, John, was in the Army and served in World War II. She had two children with her husband, one son and one daughter. Her husband passed away in December of 2004. Her daughter lives in Omaha and visits her frequently. …show more content…
Doe’s incontinence is stress, urge, and overflow related. Doe is independent for transfer abilities with some loss of balance. She does have a visual acuity deficit that is corrected with lenses and has mild hearing loss on the left side. Doe is able to communicate clearly and is oriented to person, place, time, and reality. She does have some short term memory loss. Emotional concerns include appearance of anxiousness and critical of herself. Leisure Interest Survey: Doe completed the Leisure Interest Survey on 4/16/2016. Please see attached form for results. Doe said yes when asked if she felt that leisure time was important to her. Doe stated she was satisfied with her current leisure lifestyle. She likes to read and knit in her room, but she also likes to go to bingo and social events. Doe said she participates in activities when she can. She thinks of herself as a social person, but isn’t sure if she enjoyed new challenges. When asked if she considered herself a confident person, she said no. Conclusion/Summary: Doe has a few possible leisure barriers related to her hearing deficit, her fear of her incontinence, and her lack of self-confidence. These barriers could prevent Doe from coming to various scheduled