EMPLOYER’S NAME :    XXXXXXX
AGE :                          69 yrs. old
WHO LIVE WITH HER: A man lives with his wife

LANGUAGE :                English/ Hebrew
DAY OFF :                    no day off but with pay
ROOM :                        separate room

PHYSICAL and MEDICAL CONDITIONS:

– Dimentia
– using the diaper
– using the walker inside the house

VERY NICE FAMILY